Rotator cuff tears (RCTs) are a prevalent cause of shoulder dysfunction, especially in older adults. Among the intrinsic and extrinsic factors influencing tear severity, the role of acromial morphology remains controversial. This study aims to investigate the association between acromion type, as classified by the Bigliani system, and RCT severity confirmed arthroscopically, and to assess whether age, diabetes mellitus, or hyperlipidemia are significant predictors. In this retrospective, cross-sectional study, 96 patients who underwent shoulder magnetic resonance imaging (MRI) and subsequent arthroscopy between 2020 and 2024 were randomly selected. Patients were categorized based on Bigliani acromion types (Type I, II, III). RCT size was assessed and classified intraoperatively. Multinomial logistic regression was used to identify predictors of tear severity. A significant association was found between acromion morphology and tear size (p < 0.001). Type III (hooked) acromia were strongly associated with massive tears, while Type I and II were more commonly associated with smaller tears. Increasing age was an independent predictor of larger tears. No statistically significant relationship was found between tear size and diabetes mellitus or hyperlipidemia. Hooked (Type III) acromion morphology and older age were found to be associated with greater RCT severity. Systemic metabolic comorbidities such as diabetes and hyperlipidemia did not appear to significantly affect tear extent. These findings support the potential clinical relevance of acromial morphology in preoperative assessment and risk stratification, although further prospective research is warranted. Retrospective, cross-sectional, observational study.

İyi huylu (bening) ve lokal agresif kemik tümörlerinin tedavisinde, nüks riskini azaltmak ve mekanik stabiliteyi sağlamak amacıyla cerrahi eksizyon ve rekonstrüksiyon yöntemleri kritik öneme sahiptir. Bu tümörler genellikle asemptomatik seyretse de agresif evrelerde cerrahi müdahale gerektirir ve tedavi yaklaşımı Enneking evreleme sistemine göre belirlenir. İntralezyonel veya marjinal rezeksiyon sonrasında oluşan kemik defektleri, otogreft, allogreft veya sentetik materyaller gibi biyolojik yöntemlerin yanı sıra kemik çimentosu (PMMA), plak ve çivi gibi biyolojik olmayan yöntemlerle rekonstrükte edilir. Özellikle dev hücreli tümör ve osteoblastom gibi nüks oranı yüksek olan lokal agresif tümörlerde, cerrahi sınırlardaki mikroskobik hücre kalıntılarını yok etmek amacıyla koterizasyon, argon ışık fotokoagülasyonu, fenol, etanol ve sıvı azot ile kriyoterapi gibi lokal adjuvan tedaviler uygulanır. Bu adjuvanlar, tümörün tekrarlama riskini anlamlı ölçüde düşürür. Cerrahi ve adjuvan stratejilerin doğru kombinasyonu hastaların tedavisinde başarıyı artırır. Surgical excision and reconstruction methods are of critical importance in the treatment of benign and locally aggressive bone tumors to reduce recurrence risks and ensure mechanical stability. Although these tumors are generally asymptomatic, they require surgical intervention in aggressive stages, and the treatment approach is determined according to the Enneking staging system. Bone defects occurring after intralesional or marginal resection are reconstructed using biological methods such as autografts, allografts, or synthetic materials, as well as non-biological methods including bone cement (PMMA), plates, and nails. Especially in locally aggressive tumors with high recurrence rates, such as giant cell tumors and osteoblastomas, local adjuvant therapies like cauterization, argon beam coagulation, phenol, ethanol, and cryotherapy with liquid nitrogen are applied to destroy microscopic cell residues at surgical margins. These adjuvants significantly decrease the risk of tumor recurrence. The correct combination of surgical and adjuvant strategies enhances treatment success in patients.