Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy

Abstract Purpose Rotator cuff tear arthropathy (RCTA) is characterised by humeral head migration (HHM). The exact pathogenesis of HHM is poorly understood, although rotator cuff (RC) failure and scapular anatomy are thought to play an important role. The aim of this study is to investigate the possi...

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Main Authors: Hannes E. Tytgat, Nazanin Daneshvarhasjin, Philippe Debeer, Jean Chaoui, Filip Verhaegen
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Experimental Orthopaedics
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Online Access:https://doi.org/10.1002/jeo2.70219
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author Hannes E. Tytgat
Nazanin Daneshvarhasjin
Philippe Debeer
Jean Chaoui
Filip Verhaegen
author_facet Hannes E. Tytgat
Nazanin Daneshvarhasjin
Philippe Debeer
Jean Chaoui
Filip Verhaegen
author_sort Hannes E. Tytgat
collection DOAJ
description Abstract Purpose Rotator cuff tear arthropathy (RCTA) is characterised by humeral head migration (HHM). The exact pathogenesis of HHM is poorly understood, although rotator cuff (RC) failure and scapular anatomy are thought to play an important role. The aim of this study is to investigate the possible association between HHM and the quantitative aspects of scapular anatomy and RC degeneration. Methods We analysed computed tomography scans of 43 RCTA patients. RC fatty infiltration (FI) and atrophy, HHM, and both native and pathologic scapular anatomy were quantitatively assessed in three dimensions. Results Patients with superior HHM had a significantly higher critical shoulder angle (34° vs. 30°, p = 0.009), and FI of the supraspinatus (26% vs. 16%, p = 0.025) and infraspinatus (IS) (25% vs. 16%, p = 0.038) compared to patients without superior HHM. Patients with posterior HHM had a significantly more retroverted native (mean 10° vs. 6°; p = 0.002) and pathologic glenoid (mean 11° vs. 4°; p = 0.001) and a higher anterior axis length (mean 40 mm vs. 37 mm; p = 0.001) compared to patients without anteroposterior HHM. Multivariate regression analysis showed that the native glenoid version, anterior axis length and the volume (Vol) of IS divided by subscapularis (p = 0.01) were independent predictors of the magnitude of anteroposterior HHM, together explaining 41% of its variance. Conclusion In RCTA, degeneration of the posterosuperior RC and acromion morphology seems to be associated with superior HHM, while in the glenoid version, the rotational alignment of the coracoacromial complex and an imbalance in FI and muscle Vol in the transverse force couple seems to be associated with anteroposterior HHM. Level of Evidence Level III.
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spelling doaj-art-93b89bebae5d47989f1dd093dbb6ea312025-08-20T03:44:05ZengWileyJournal of Experimental Orthopaedics2197-11532025-04-01122n/an/a10.1002/jeo2.70219Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathyHannes E. Tytgat0Nazanin Daneshvarhasjin1Philippe Debeer2Jean Chaoui3Filip Verhaegen4Department of Orthopedics UZ Leuven Leuven BelgiumDepartment of Orthopedics UZ Leuven Leuven BelgiumDepartment of Orthopedics UZ Leuven Leuven BelgiumDigital Technologies Trauma & Extremities, Stryker Portage Michigan USADepartment of Orthopedics UZ Leuven Leuven BelgiumAbstract Purpose Rotator cuff tear arthropathy (RCTA) is characterised by humeral head migration (HHM). The exact pathogenesis of HHM is poorly understood, although rotator cuff (RC) failure and scapular anatomy are thought to play an important role. The aim of this study is to investigate the possible association between HHM and the quantitative aspects of scapular anatomy and RC degeneration. Methods We analysed computed tomography scans of 43 RCTA patients. RC fatty infiltration (FI) and atrophy, HHM, and both native and pathologic scapular anatomy were quantitatively assessed in three dimensions. Results Patients with superior HHM had a significantly higher critical shoulder angle (34° vs. 30°, p = 0.009), and FI of the supraspinatus (26% vs. 16%, p = 0.025) and infraspinatus (IS) (25% vs. 16%, p = 0.038) compared to patients without superior HHM. Patients with posterior HHM had a significantly more retroverted native (mean 10° vs. 6°; p = 0.002) and pathologic glenoid (mean 11° vs. 4°; p = 0.001) and a higher anterior axis length (mean 40 mm vs. 37 mm; p = 0.001) compared to patients without anteroposterior HHM. Multivariate regression analysis showed that the native glenoid version, anterior axis length and the volume (Vol) of IS divided by subscapularis (p = 0.01) were independent predictors of the magnitude of anteroposterior HHM, together explaining 41% of its variance. Conclusion In RCTA, degeneration of the posterosuperior RC and acromion morphology seems to be associated with superior HHM, while in the glenoid version, the rotational alignment of the coracoacromial complex and an imbalance in FI and muscle Vol in the transverse force couple seems to be associated with anteroposterior HHM. Level of Evidence Level III.https://doi.org/10.1002/jeo2.70219glenoid versionhumeral head migrationrotator cuff arthropathyrotator cuff atrophyrotator cuff fatty infiltrationscapular anatomy
spellingShingle Hannes E. Tytgat
Nazanin Daneshvarhasjin
Philippe Debeer
Jean Chaoui
Filip Verhaegen
Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy
Journal of Experimental Orthopaedics
glenoid version
humeral head migration
rotator cuff arthropathy
rotator cuff atrophy
rotator cuff fatty infiltration
scapular anatomy
title Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy
title_full Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy
title_fullStr Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy
title_full_unstemmed Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy
title_short Association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy
title_sort association of rotator cuff degeneration and scapular anatomy with humeral head migration in rotator cuff arthropathy
topic glenoid version
humeral head migration
rotator cuff arthropathy
rotator cuff atrophy
rotator cuff fatty infiltration
scapular anatomy
url https://doi.org/10.1002/jeo2.70219
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