# Comparative Study of the Acromioglenoid Angle and Critical Shoulder Angle in Assessing the Role of Scapular Morphology in Primary Glenohumeral Osteoarthritis

## TL;DR

This study compares two radiological angles to assess their usefulness in predicting shoulder osteoarthritis, finding both to be effective.

## Contribution

The study evaluates AGA and CSA as complementary tools for predicting glenohumeral osteoarthritis.

## Key findings

- AGA and CSA were significantly lower in the GHOA group compared to the non-GHOA group.
- AGA and CSA showed strong positive correlations in both GHOA and non-GHOA groups.
- AGA is a useful addition to CSA for clinical assessment and surgical planning in GHOA.

## Abstract

Introduction

Glenohumeral osteoarthritis (GHOA) is a common degenerative shoulder disorder. Individual scapular morphology, including glenoid inclination and acromial extension, has been implicated in shoulder biomechanics and disease risk. This study was conducted to assess the comparative efficacy of acromioglenoid angle (AGA) and critical shoulder angle (CSA) as radiological parameters for predicting GHOA.

Methods

A cross-sectional observational study was conducted at All India Institute of Medical Sciences, Rajkot, involving 277 shoulder radiographs in true anteroposterior (AP) view. Participants were divided into GHOA and non-GHOA groups based on radiographic findings. Both CSA and AGA were measured independently by two observers using standardized methodology. Statistical analysis included the intraclass correlation coefficient (ICC) for reliability, Pearson correlation for association analysis, and logistic regression for predictive value determination.

Results

Among 277 shoulders analysed, 158 showed radiographic evidence of GHOA (mean age 65.3 ± 12.4 years; 91 males, 67 females) and 119 were non-GHOA group (mean age 52.1 ± 10.8 years; 62 males, 57 females). Mean CSA was significantly lower in the GHOA group (32.5° ± 2.8°) compared to the non-OA group (36.9° ± 2.3°; t = 13.95, p < 0.001). Similarly, mean AGA was significantly reduced in GHOA patients (44.4° ± 2.7°) versus the non-OA group (50.1° ± 2.8°; t = 17.1, p < 0.001). Strong positive correlation existed between AGA and CSA in both GHOA (r = 0.530, p < 0.001) and non-GHOA groups (r = 0.703, p < 0.001).

Conclusions

Both AGA and CSA are useful radiological measures for predicting GHOA, and there are statistically significant correlations between them. When measuring from the midglenoid reference point, AGA is a useful addition to CSA for clinical assessment and surgical planning for individuals with GHOA.