Yunfeng Mi1,2, Yi Lin3, Biao Cheng4

1Tongji University, School of Medicine, Shanghai, China
2Department of Orthopedics, Ningbo First Hospital, The First Affiliated Hospital of Ningbo University, Ningbo, China
3Center for Health Economics, Faculty of Humanities and Social Sciences, University of Nottingham, Ningbo, Zhejiang Province, China
4Department of Orthopedics, Tongji Hospital of Tongji University, Shanghai, China

Keywords: Coracoid humeral distance, coracoid morphology, coracoid overlap, magnetic resonance imaging, subcoracoid impingement.


Objectives: This study aims to assess the association between isolated subscapularis tears and coracoid morphology using magnetic resonance imaging (MRI) and to calculate the optimal cut-off values of the significant predictor to predict subscapularis tears.

Patients and methods: Between January 2018 and December 2022, a total of 60 patients (29 males, 31 females; mean age: 58.4±8.4 years; range, 18 to 80 years) diagnosed with subscapularis tendon tears who were treated as Group A and 60 patients (29 males, 31 females; mean age: 46.8±11.5 years; range, 18 to 80 years) without subscapularis tendon tears who were treated as Group B were included. Axial coracoid-humeral distance (aCHD), sagittal coracoid-humeral distance (sCHD), coracoid overlap (CO) and coracoid angle (CA) of all patients were measured. Logistic regression was used to investigate the association between subscapularis tears as variables including aCHD, sCHD, CO and CA. Receiver operating characteristic curve analysis was used to determine the diagnostic values of coracoid morphology for subscapularis tears.

Results: The mean values of CO, aCHD and sCHD in Group A were 22.16 mm, 5.13 mm, and 5.56 mm, respectively. The mean values in Group B were 16.99 mm, 7.18 mm, and 7.29 mm, respectively. The degree of CA in Group A was 95.81 and 111.69 in Group B. The differences in the above measurement values were significant between two Groups. The CO was found to be associated with higher odds of subscapularis tears. The optimal cut-off value of CO was 19.79 mm.

Conclusion: Based on our study results, CO is positively associated with isolated subscapularis tears. In addition, coracoid bursa effusion, cysts in the lesser tuberosity or a tear and malposition of long head of the biceps tendon on MRI may predict the presence of a clinically significant subscapularis tear.

Citation: Mi Y, Lin Y, Cheng B. Magnetic resonance imaging based coracoid process morphology and its associations with isolated subscapularis tendon tears in Chinese patients. Jt Dis Relat Surg 2024;35(2):267-275. doi: 10.52312/jdrs.2024.1587.

Ethics Committee Approval

The study protocol was approved by the Ningbo First Hospital Ethics Committee (date: 15.07.2019, no: 20190715). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

The concept and design of the study, data collection and analysis: YF.M.; Drafting the article or revising it critically for important intellectual content: Y.L.; Final approval of the version to be submitted: YF.M., B.C. All authors have read and approved the manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.