Clinical implications of reverse total shoulder arthroplasty with an os acromiale: a systematic review
Bibliographic record
Abstract
Background: Os acromiale is defined as a developmental failure of fusion of one of the primary ossification centers of the acromion. This anatomic variant can be identified in the presentation and workup of patients with various shoulder pathologies. Reverse total shoulder arthroplasty (rTSA) is a common surgical procedure for a multitude of underlying conditions. The purpose of this study was to conduct a systematic review of the literature to determine the clinical implications of rTSA in those with os acromiale. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA checklist. In April 2024, the following online databases were accessed: PubMed, Embase, and Cochrane. All clinical studies assessing os acromiale in rTSA were considered for inclusion and evaluated. Results: The initial search result provided 569 studies to be assessed. After careful screening, 4 studies were included in this systematic review. A total of 573 patients undergoing rTSA with underlying os acromiale were included in this review. The prevalence of os acromiale in patients undergoing rTSA ranged from 5% to 22%. All patients had improvements in patient reported outcome measures with minimal complications. The most common radiographic finding was inferior tilting of the os acromiale. Conclusion: The presence of os acromiale does not appear to have a negative impact on the clinical outcomes after surgery and rTSA remains a safe and effective treatment option.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.007 |
| Bibliometrics | 0.010 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".