# Scapular morphology does not predict supraspinatus tendon tear propagation following an individualised exercise therapy programme

## TL;DR

This study found that scapular shape does not reliably predict whether a supraspinatus tendon tear will worsen after a 12-week exercise therapy program.

## Contribution

The study challenges the assumption that scapular morphology predicts supraspinatus tendon tear progression after exercise therapy.

## Key findings

- 81.4% of participants experienced no change in tear size after therapy.
- CSA and acromion morphology were not significant predictors of tear propagation.
- The model only predicted tear propagation in 8.3% of cases.

## Abstract

To determine whether scapular morphology could predict isolated supraspinatus tendon tear propagation after exercise therapy. We hypothesised that a larger critical shoulder angle (CSA) and type III acromial morphology predict a positive change in tear size.

Fifty‐nine individuals aged 40–70 years with isolated symptomatic high‐grade partial or full‐thickness supraspinatus tendon tears were included. Individuals participated in a structured, individualised 12‐week exercise therapy programme and underwent ultrasound to measure tear size at baseline and 12 months following therapy. Computed tomography images were segmented to create three‐dimensional subject‐specific bone models and reviewed by three trained clinicians to measure CSA and to determine acromion morphology based on the Bigliani classification. A binary logistic regression was performed to determine the predictive value of CSA and acromion morphology on tear propagation.

The CSA was 30.0 ± 5.4°. Thirty‐one individuals (52.5%) had type II acromial morphology, followed by type III and type I morphologies (25.4% and 22.0%, respectively); 81.4% experienced no change in tear size, four (6.8%) individuals experienced tear propagation and seven (11.9%) individuals had a negative change in tear size. No significant difference in tear propagation rates based on CSA or acromion morphology (not significant [NS]) was observed. The model predicted tear size status in 81.4% of cases but only predicted tear propagation 8.3% of the time. Overall, CSA and acromion morphology only predicted 24.3% (R
2 = 0.243) of variance in tear propagation (NS).

CSA and acromion morphology were NS predictors of tear propagation of the supraspinatus tendon 12 months following an individualised exercise therapy programme.

II.