Acromioplasty

BACKGROUND: Augmentation with subacromial bursa has not been fully established in bursal-sided partial-thickness rotator cuff tears (PT-RCTs). PURPOSE: To compare the results of acromioplasty + arthroscopic debridement versus acromioplasty + augmentation with subacromial bursa for Ellman type 2 PT-RCTs involving 25% to 50% of the tendon surface area. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Included were 40 patients (mean age, 47...

In this study, we introduce an arthroscopic acromioplasty technique based on original bony landmarks, namely biplanar acromioplasty. This technique focuses on smoothing both the coronal and transverse plane of acromion, corresponding to the anterior and inferior acromial surface, and restores the acromion to its original shape. We believe this technique is effective, time-saving, and reproducible.

Subacromial decompression with acromioplasty is among the most commonly performed shoulder procedures. The advantages of in-office nano-arthroscopy include the capability of diagnosing and treating subacromial impingement, swifter patient recovery, improved cost-effectiveness, and superior patient satisfaction. The purpose of this technical report is to describe our technique for performing in-office nano-arthroscopy for subacromial decompression (subacromial bursectomy and acromioplasty), with a particular focus on appropriate indications, providing sufficient local anesthesia, optimizing visualization, and discussing the advantages of the in-office setting compared to the operating room...

BACKGROUND: Coracoacromial ligament (CAL) degeneration is thought to be a factor in external impingement in bursal-sided rotator cuff tears, but CAL release is associated with adverse effects. PURPOSE: To investigate the association between CAL degeneration and the patterns of massive rotator cuff tears using multiple modalities and to assess the effect of CAL degeneration on supraspinatus tendon retear rates. STUDY DESIGN: Cohort study; Level of evidence, 2...

BACKGROUND: Limited knowledge exists regarding prognostic factors after rotator cuff repair. PURPOSE: To identify pre- and perioperative predictors for functional outcomes after arthroscopic rotator cuff repair. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: This study included patients who underwent arthroscopic rotator cuff repair between January 2013 and April 2019 and who had preoperative magnetic resonance imaging scans...

PURPOSE: To compare outcomes of reverse total shoulder arthroplasty (RTSA) in patients with prior arthroscopic acromioplasty versus a control group of patients with no history of acromioplasty. METHODS: We performed a retrospective matched-cohort study of patients from a single institution who underwent RTSA with a history of acromioplasty from 2009 to 2017 with a minimum 2-year follow-up period. Patients' clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons shoulder score and Simple Shoulder Test, visual analog scale, and Single Assessment Numeric Evaluation surveys...

BACKGROUND: Tranexamic acid (TXA) is widely used in hip and knee arthroplasty to reduce perioperative bleeding. Recently, its use has been expanded to arthroscopic surgery. The purpose of this study was to evaluate the efficacy of preoperative use of TXA in arthroscopic rotator cuff repair (RCR). METHODS: A cohort comprising 129 consecutive patients who underwent arthroscopic primary RCR at our institution was retrospectively investigated according to whether they received TXA (April 2018 to December 2020, TXA group, n = 64) or did not receive TXA (April 2016 to March 2018, non-TXA group, n = 65)...

No abstract text is available yet for this article.

BACKGROUND: Retearing of the supraspinatus (SSP) tendon after repair is relatively common, but its cause is rarely clear. Although the role of acromion morphology and glenoid orientation in the pathogenesis of primary SSP tendon tears have frequently been analyzed, their association with the risk of rerupture of a repaired SSP tendon is poorly understood. QUESTIONS/PURPOSES: (1) Is acromial morphology associated with the risk of retear after SSP tendon repair? (2) Is there an association between inclination and version of the glenoid and the odds for retear of the SSP tendon after repair? (3) Are there differences in outcome scores between patients who had intact cuff repairs and those who had retears? METHODS: Between August 2012 and December 2015, we treated 92 patients for SSP tendon tears; all of these patients were considered for inclusion in the present study...

The pathogenesis of subacromial impingement syndrome is controversially discussed. Assuming that bursal sided partial tears of the supraspinatus tendons are rather the result of a direct subacromial impact, the question arises whether there is a morphological risk configuration of the acromion and its spatial relation to the glenoid. Patients who underwent arthroscopic repair of either a partial articular supraspinatus tendon avulsion (PASTA) or bursal-sided supraspinatus tear (BURSA) were retrospectively allocated to two groups...

There are 2 distinct types of rotator cuff tears. The first is a chronic, degenerative tear, which is more common. The second is an acute traumatic tear. (There is also likely a third, hybrid type consisting of an acute-on-chronic tear) Traumatic tears result in acute dysfunction with weakness and loss of range of motion. Traumatic tears are large to massive in size and have higher degrees of subscapularis involvement. If a patient has an acute cuff tear, the surgeon should fix it. The surgeon should not take the time to measure the critical shoulder angle (CSA) or plan an acromioplasty but should just fix the tear-the sooner, the better...

PURPOSE: To evaluate the mid-term rate of revision arthroscopic rotator cuff repair as well as ipsilateral shoulder reoperations after index rotator cuff repair performed with or without acromioplasty in the United States. METHODS: The Medicare Standard Analytic File, which encompasses the entire Medicare billing and payment data, was queried between 2005 and 2014. Patients undergoing arthroscopic rotator cuff repair were identified and stratified based on whether ipsilateral acromioplasty was concurrently performed using Current Procedural Terminology codes...

The surgical treatment of massive rotator cuff tears is a clinical challenge for orthopaedic surgeons. Moreover, tendon retraction, adhesions and fatty infiltration after rotator cuff tear will further increase the difficulty of surgical repair. Therefore, it has become a hotspot and difficulty to repair massive rotator cuff tears with a better way in current research. In recent years, with the continuous development of arthroscopic techniques, shoulder arthroscopic surgery has become the gold standard for the treatment of massive rotator cuff tears, but the adaptations, effects and combined application of different surgical methods are still controversial...

No abstract text is available yet for this article.

BACKGROUND: The aim of this study was to reevaluate patients from a previous randomized controlled trial at a long-term follow-up to determine the long-term efficacy of subacromial decompression in patients with full-thickness rotator cuff tears. METHODS: This is a secondary study based on a previous, multicenter, randomized controlled trial with patients allocated to arthroscopic rotator cuff repair with or without acromioplasty. The original study was conducted between 2003 and 2011, and the secondary study was conducted between 2015 and 2021...

The shoulders with critical shoulder angle (CSA) of greater than 33-35° are associated with rotator cuff tears, whereas a CSA of less than 30° is likely to be osteoarthritic. However, anterior acromioplasty or lateral acromioplasty could not reduce high CSAs to the desired range (30-33°), with satisfactory accuracy and efficacy. Thus, we introduce a computer image-guided precise acromioplasty (CIG-PAP) technique, an individualized treatment based on three-dimensional planning. We believe that the introduction of this technique will provide an alternative approach to reduce a large CSA to the desired range (30-33°)...

BACKGROUND: The purpose of this study was to define the features of scapular morphology that are associated with changes in the critical shoulder angle (CSA) by developing the best predictive model for the CSA based on multiple potential explanatory variables, using a completely 3D assessment. METHODS: 3D meshes were created from CT DICOMs using InVesalius (Vers 3.1.1, RTI [Renato Archer Information Technology Centre], Brazil) and Meshmixer (3.4.35, Autodesk Inc...

Despite its time-honored tradition, the classic Neer acromioplasty has come under increased scrutiny in the recent literature, particularly when performed in the absence of rotator cuff repair. The American Medical Association Current Procedural Terminology Committee has transitioned the acromioplasty procedure, and definition of the related Current Procedural Terminology code 29827, to a procedure that is "added-on" to shoulder arthroscopy. Several authors have sought to investigate the true value of arthroscopic subacromial decompression for extrinsic sources of impingement...

Purpose: To compare plain radiographs with 3-dimensional (3D) computed tomography (CT) data for preoperative planning of arthroscopic lateral acromioplasty (ALA) for patients in whom ALA was performed along with arthroscopic rotator cuff repair (ARCR). Methods: Patients older than 25 years old who underwent ALA along with ARCR in our institution between October 2019 and February 2021 were included in this study. Preoperative ALA simulations were performed on plain radiographs and 3D models based on CT data...

MR imaging is crucial in the evaluation of symptomatic patients who have undergone rotator cuff surgery. Familiarity with anatomic rotator cuff repair and the other surgical options for irreparable cuff tears, expected normal postoperative findings, and potential complications is essential for better MR imaging interpretation.