Cerciello Simone, Mocini Fabrizio, Proietti Lorenzo, Candura Dario, Corona Korona
Department of Orthopedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Sacred Heart Catholic University, Rome.
Casa di Cura Villa Betania, Rome, Italy.
Sports Med Arthrosc Rev. 2024 Mar 1;32(1):38-45. doi: 10.1097/JSA.0000000000000397. Epub 2024 May 2.
The pathogenesis of rotator cuff tears (RCTs) is multifactorial. Critical shoulder angle (CSA), which represents the lateral extension of the acromion over the cuff, has been proposed as an extrinsic risk factor. The aim of the present systematic review and meta-analysis was to analyze the available literature regarding the correlation between RCT and CSA.
A review was carried out in accordance with the "Preferred Reporting Items for Systematic reviews and Meta-Analyses" guidelines on July 17, 2023, using the following databases: PubMed, Ovid, and Cochrane Reviews. The following keywords were used: "critical shoulder angle," "rotator cuff tears," and "rotator cuff lesions." The methodological quality of the studies was assessed with the MINORS SCORE.
Twenty-eight studies were included. The average CSA among the 2110 patients with full-thickness RCT was 36.7 degrees, whereas the same value among the 2972 controls was 33.1 degrees. The average CSA in the 348 patients with partial-thickness RCT was 34.6 degrees, whereas it was 38.1 degrees in the 132 patients with massive RCT. The average MINORS score was 15.6.
CSA values were significantly higher in patients with RCT compared with the asymptomatic population. In addition, it appears that CSA values increase with the severity of rotator cuff involvement.
肩袖撕裂（RCT）的发病机制是多因素的。关键肩角（CSA）代表肩峰在肩袖上的外侧延伸，已被提出作为一种外在风险因素。本系统评价和荟萃分析的目的是分析关于RCT与CSA之间相关性的现有文献。
于2023年7月17日按照“系统评价和荟萃分析的首选报告项目”指南进行综述，使用以下数据库：PubMed、Ovid和Cochrane综述。使用了以下关键词：“关键肩角”、“肩袖撕裂”和“肩袖损伤”。采用MINORS评分评估研究的方法学质量。
纳入28项研究。2110例全层RCT患者的平均CSA为36.7度，而2972例对照者的该值为33.1度。348例部分厚度RCT患者的平均CSA为34.6度，而132例大面积RCT患者的平均CSA为38.1度。平均MINORS评分为15.6。
与无症状人群相比，RCT患者的CSA值显著更高。此外，似乎CSA值随着肩袖受累程度的加重而增加。
