Thursday, November 3, 2011

Acromioplasty and cuff repair in the recent JBJS

In Volume 983 Issue 21 of the Journal of Bone and Joint Surgery, MacDonald et al published an article on Arthroscopic Rotator Cuff Repair with and without Acromioplasty in the Treatment of Full-Thickness Rotator Cuff Tears: A Multicenter, Randomized Controlled Trial. They used the Western Ontario Rotator Cuff (WORC) index and the American Shoulder and Elbow Surgeons (ASES) questionnaires to asses the results of repairs of full thickness rotator cuff repairs (less than or equal to 4 centimeters in size) up to two years after surgery. The repair technique was a single row arthroscopic technique. 86 patients were randomized to acromioplasty or non-acromioplasty groups

Scores improved significantly in each group over time (p < 0.001). There were no differences in scores between the groups that had arthroscopic cuff repair with or without acromioplasty at any time point. There were no differences in scores on the basis of acromion type, nor were any interaction effects identified between group and acromion type. Four participants (9%) in the group that had arthroscopic cuff repair alone, one with a Type-2 and three with a Type-3 acromion, required additional surgery by the twenty-four-month time point. The number of patients who required additional surgery was greater (p = 0.05) in the group that had arthroscopic cuff repair alone than in the group that had arthroscopic cuff repair and acromioplasty. The reasons for this difference is not clear. Possibly it could be related to increased surgical exposure offered by acromioplasty.

These results are consistent with the result of research pointing to the lack of level I or level II evidence in support of the 'impingement syndrome' and the use of acromioplasty to manage it.


Use the "Search the Blog" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including: shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery.