The Effect of Acromioplasty or Bursectomy on the Results of Arthroscopic Repair of Full Thickness Rotator Cuff Tears: Does the Acromion Type Affect These Results?

Abstract

Introduction: The aim of this study was to investigate the effect of subacromial decompression on the results of full thickness rotator cuff repair applied arthroscopically. Examination was also made of the effect of acromion type on the subacromial decompression procedure in patients applied with arthroscopic rotator cuff repair. Materials and Methods: The study included a total of 150 patients, comprising 102 (68%) females and 48 (32%) males with a full thickness rotator cuff tear repaired arthroscopically. The patients were separated into 3 groups of 50. Group A comprised those with acromioplasty and bursectomy applied additional to the repair. In Group B, only bursectomy was performed additional to the repair and in Group C, only rotator cuff repair was applied. Evaluation was made of the postoperative long-term pain and functional results. Results: The mean age of the cases was 65.63±9.22 years (range, 46-86 years). The affected side was right side in 95 (63.3%) cases and left side in 55 (36.7%). No statistically significant difference was determined between the groups according to the postoperative Constant Murley and ASES scores (p>0.05). In the paired comparisons, the postoperative VAS scores of Group C were higher than those of Groups A and B (p=0.018, p=0.029, p<0.05). No statistically significant difference was determined between Group A and Group B in respect of the postoperative VAS scores (p>0.05). Conclusions: In the arthroscopic repair of full thickness rotator cuff tears, neither acromioplasty, coraco-acromial ligament loosening nor bursectomy were determined to have any positive effect on the results. Whatever the acromion type, there is no need for an additional subacromial decompression procedure after rotator cuff repair, in respect of pain and functional outcomes. Only acromial spurs should be gently removed paying attention to the coraco-acromial ligament.

Effect of Arthroscopic Acromioplasty Combined with Rotator Cuff Repair in the Treatment of Aged Patients with Full-Thickness Rotator Cuff Tear and Rotator Cuff Injury

“…e above conclusions further confirmed the significance of acromioplasty. However, it is important to note that acromioplasty may lead to shoulder instability when there is a huge rotator cuff tear or a hard-to-repair rotator cuff injury [23]. erefore, in order to further ensure the effectiveness of the combined surgical plan, care should be taken in performing acromioplasty, and the evaluation of shoulder function should be perfected before surgery.…”

The Role of the Subacromial Bursa in Rotator Cuff Healing

“…Despite this, the approach gained a vibrant following and is widely cited as the motivation behind the now liberal use of subacromial decompression in shoulder surgery. This shift away from Codman's declaration of the bursa as essential for shoulder function and toward the regular practice of bursectomy largely persisted until recent years, when uncertainty about the efficacy of complete bursectomy resurfaced 21,[30][31][32][33] . In fact, the most recent reports appear to be swaying back toward a Codman-like mindset, demonstrating improved long-term outcomes for patients who undergo rotator cuff repair without subacromial decompression 34 .…”