Mid-term results of arthroscopic subacromial decompression in patients with or without partial thickness rotator cuff tears

Abstract

Aim:To evaluate mid-term outcome in patients who underwent arthroscopic subacromial decompression (ASD) for shoulder impingement syndrome with intact and partially torn rotator cuffs.Materials and Methods:A total of 80 consecutive patients (83 shoulders) who underwent ASD for impingement syndrome between 2003 and 2006 were analyzed. Mean age was 57.1 years. Patients’ self-reported Oxford Shoulder Score (OSS) for pain was collected prospectively and was used as an instrument to measure surgical outcome.Results:The mean initial and final OSS for patients with an intact rotator cuff was 26.1 and 40.3, respectively, at a mean follow up of 71.9 months (nearly 7 years). The mean initial and final OSS for patients with a partially torn articular sided tear was 22.6 and 41.9, respectively, at mean follow up of 70.7 months. Both groups showed significant sustained improvement (P < 0.0001). The mean improvement of OSS following ASD was statistically greater (P < 0.03) for partially torn rotator cuff group (19.3 points) as compared to those with normal rotator cuff (14.2 points).Conclusion:Patients with dual pathology (partial rotator cuff tear and impingement) appreciated a significantly greater improvement following ASD compared to those with impingement alone. Both groups of patients had a similar final outcome at a mid-term follow up.Level of Evidence:IV, retrospective study on consecutive series of patients.

The Coracoacromial Ligament: Anatomy, Function, and Clinical Significance

“… 28 Partial resection of the CAL has been reported elsewhere without any apparent postoperative complications related to its release. 13 , 29 Interestingly, the CAL has been shown to reform spontaneously with the same orientation, gross appearance, and viscoelastic properties within a few years of release. 20 …”