The Changing Role of Acromioplasty

Cincinnati, Ohio.
Arthroscopy The Journal of Arthroscopic and Related Surgery (Impact Factor: 3.21). 08/2012; 28(8):1047-8; author reply 1048-9. DOI: 10.1016/j.arthro.2012.06.003
Source: PubMed
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    ABSTRACT: The treatment of rotator cuff injury in the absence of a full-thickness tear has traditionally consisted of acromioplasty. However, this disorder may also be treated by arthroscopic rotator cuff debridement without acromioplasty. Our previous study of 79 shoulders so treated reported 87% good or excellent results at an average 53-month follow-up. The purpose of this article is to report the long-term, average 9.5-year follow-up of this cohort. Long-term follow-up of case series. We retrospectively reviewed the records of 62 shoulders in 60 patients who had undergone arthroscopic rotator cuff debridement for partial-thickness rotator cuff tears. Demographic criteria, residual pain, and the ability to return to recreational athletics were noted. The UCLA Shoulder Score and the Simple Shoulder Test scores were determined and statistical analysis performed. Using the UCLA Shoulder Score, there were 79% excellent or good results at an average 114 months of follow-up. Patients with Workers' Compensation claims had significantly worse results, with only 40% rated good or excellent. Of the 60 patients, 77% had no or only minimal pain, 57% were still able to perform recreational athletics without difficulty, and 20% could participate at a lower level of intensity. Arthroscopic debridement of rotator cuff injury in the absence of a full-thickness tear has good long-term results and minimizes additional surgical trauma. Level IV, case series.
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    ABSTRACT: The purpose of this study was to determine the efficacy of arthroscopic repair of full-thickness rotator cuff tears with and without subacromial decompression. We searched the Cochrane Central Register of Controlled Trials (third quarter of 2011), Medline (1948 to week 1 of September 2011), and Embase (1980 to week 37 of 2011) for eligible randomized controlled trials. Two reviewers selected studies for inclusion, assessed methodologic quality, and extracted data. Pooled analyses were performed by use of a random effects and relative risk model with computation of 95% confidence intervals. We included 4 randomized trials and 373 patients. Methodologic quality was variable as assessed by the CLEAR NPT (Checklist to Evaluate a Report of a Non-pharmacological Trial) tool. One trial showed that there was no difference in disease-specific quality of life (Western Ontario Rotator Cuff questionnaire) between the 2 treatment groups. A meta-analysis of shoulder-specific outcome measures (American Shoulder and Elbow Surgeons or Constant scores) or the rate of reoperation between patients treated with subacromial decompression and those treated without it also showed no statistically significant differences. On the basis of the currently available literature, there is no statistically significant difference in subjective outcome after arthroscopic rotator cuff repair with or without acromioplasty at intermediate follow-up. Level I, systematic review of Level I studies.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 02/2012; 28(5):720-7. DOI:10.1016/j.arthro.2011.11.022 · 3.21 Impact Factor
  • JAMA The Journal of the American Medical Association 04/2012; 307(15):1641-3. DOI:10.1001/jama.2012.482 · 35.29 Impact Factor