Arthroscopic Acromioplasty Research Articles

Effect of Arthroscopic Acromioplasty on the Isometric Abduction Strength.

Introduction Acromioplasty is a widely performed procedure for various rotator cuff pathologies with good outcomes and high patient satisfaction. However, few studies have focused on its potential complications. Previous cadaveric studies have demonstrated that a considerable portion of the deltoid muscle is detached from its acromial origin following arthroscopic acromioplasty, but the clinical relevance of this muscle detachment has not been investigated. The goal of our research was to examine the influence of arthroscopic acromioplasty on abduction strength and to assess whether acromial anatomy plays a role in any potential effect. Methods From a preliminary sample of 87 individuals who were diagnosed with isolated impingement syndrome and underwent arthroscopic acromioplasty, 74 patients who met the inclusion criteria were ultimately included in the study. The patients were divided into two groups according to their acromion morphology: Bigliani type 2 (33 patients) and type 3 (41 patients). The isometric abduction strength of the two groups was measured by a handheld dynamometer (Isobex®; Cursor AG, Berne, Switzerland) at different abduction angles preoperatively and at the first, third, and sixth months following surgery and was statistically compared. Results Both groups showed reduced abduction strength postoperatively; however, the strength of abduction in the Bigliani type 3 group returned to near preoperative values in the third month. Although increased mean abduction strength was recorded at 30° abduction in the sixth month, this difference was not statistically significant (p=0.78). In the Bigliani type 2 group, compared with those in the sixth-month group, the preoperative abduction strength decreased from 8.32 kg to 6.0 kg (p = 0.047), 6.57 kg to 5.15 (p = 0.025), and 6.1 kg to 4.56 kg (p = 0.006) at 30, 60, and 90° abduction, respectively. Conclusions Arthroscopic acromioplasty decreased isometric abduction strength in patients with a Bigliani type 2 acromion. Patients should be counseled about this loss, which might be especially important for professional athletes and heavy manual workers.

Retraction to: Clinical outcome of arthroscopic acromioplasty vs. arthroscopic rotator cuff repair for irreparable rotator cuff tears: A 3-year follow-up.

This article has been retracted, and the online PDF has been watermarked ``RETRACTION''. The retraction notice is available at http://doi.org/10.3233/THC249001.

Retracted: 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.

[This retracts the article DOI: 10.1155/2022/4475087.].

Arthroscopic Biological Augmentation With Subacromial Bursa for Bursal-Sided Partial-Thickness Rotator Cuff Tears.

Augmentation with subacromial bursa has not been fully established in bursal-sided partial-thickness rotator cuff tears (PT-RCTs). 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. Cohort study; Level of evidence, 3. Included were 40 patients (mean age, 47.8 years) with Ellman type 2 PT-RCTs whose symptoms did not regress despite 3 months of nonoperative treatment. The patients underwent either acromioplasty + debridement (group A; n = 18) or acromioplasty + augmentation (group B; n = 22). Outcome scores (visual analog scale [VAS] pain score, Constant-Murley score [CMS], and American Shoulder and Elbow Surgeons [ASES] score) were obtained preoperatively and at 6, 12, and 18 months postoperatively. Magnetic resonance imaging (MRI) scans performed at 6 months postoperatively were used to determine the integrity and state of healing. There were no significant differences between groups A and B in preoperative VAS, CMS, or ASES scores, and patients in both groups saw significant improvement at each follow-up time point on all 3 outcome scores (P = .001 for all). Scores on all 3 outcome measures were significantly better in group B than group A at each postoperative time point (P < .05 for all). Postoperative MRI scans revealed persistent partial tears in 5 of 18 patients in group A compared with 2 of 22 patients in group B (P < .05). Conversion to full-thickness tear (3/18 patients) was seen only in group A. Patients who underwent biological augmentation of their PT-RCTs had improved outcome scores compared with those treated with acromioplasty and debridement alone.

Biplanar Acromioplasty: An Arthroscopic Spur Removal Technique Based on Original Bony Landmarks

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.

Prior Acromioplasty Provides Similar Outcomes and Rate of Postoperative Complications Including Acromial Fracture After Reverse Total Shoulder Arthroplasty: A Retrospective Matched-Cohort Analysis

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. 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. Postoperative radiographs and patient charts were reviewed to determine whether patients sustained a postoperative acromial fracture. Charts were reviewed to determine range of motion and postoperative complications. Patients were matched on a 1:1 basis to a cohort of patients who underwent RTSA without a history of acromioplasty, and comparisons were performed using t and χ2 tests. Forty-five patients who underwent RTSA with a history of acromioplasty met the inclusion criteria and completed the outcome surveys. There were no significant differences between cases and controls in post-RTSA American Shoulder and Elbow Surgeons, visual analog scale, Simple Shoulder Test, or Single Assessment Numeric Evaluation outcome scores. There was no difference in the postoperative acromial fracture rate between cases and controls (P= .577). Overall, more complications occurred in the study group (n= 6, 13.3%) compared with the control group (n= 4, 8.9%); however, this difference was not statistically significant (P= .737). After RTSA, patients who have undergone a prior acromioplasty have similar functional outcomes without a significant difference in the rate of postoperative complications compared with patients with no history of acromioplasty. Furthermore, previous acromioplasty does not increase the risk of acromial fracture after RTSA. Level III, retrospective comparative study.

Radiographs Are Comparable With 3-Dimensional Computed Tomography-Based Models as a Modality for the Preoperative Planning of the Arthroscopic Lateral Acromioplasty: A Retrospective Comparative Study

PurposeTo 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).MethodsPatients 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. The critical shoulder angle (CSA) was compared between simulations based on radiographs and those based on 3D models. The ALA procedure was performed using the 3D model simulation, along with ARCR. The CSA after surgery was investigated using radiographs.ResultsWe evaluated 11 shoulders in 10 patients. There was no significant difference between the mean preoperative CSA on radiographs and 3D models (38.0° ± 2.6° vs 38.6° ± 1.8°, respectively; P = .55). The mean CSA after 4-mm ALA simulation using radiographs was not significantly different to that using 3D models (34.1° ± 2.6° vs 34.3° ± 2.5°, respectively; P = .84). Four cases (36.4%) required 8-mm ALA to reduce the CSA to <35° on radiographic analysis, and 2 (18.2%) required 8-mm ALA on 3D model analysis. The mean CSA on postoperative radiographs was significantly smaller than that on preoperative radiographs (32.1° ± 2.7° vs 38.0° ± 2.6°, respectively; P < .01).ConclusionsThere was no significant difference between the mean CSA after a 4-mm ALA simulation using radiographs and that using 3D models based on preoperative CT data, which suggests that radiographs are comparable with 3D CT data models as a reliable modality for the preoperative simulation of ALA.Level of EvidenceIII, retrospective comparative study.

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.

Full-thickness rotator cuff tear and rotator cuff injury are frequently occurring diseases and widely exist in the social population. Surgical repair is the most effective treatment for rotator cuff tears and injuries. With the continuous development of arthroscopy, more and more surgeons choose arthroscopic acromioplasty plus rotator cuff repair for the treatment of rotator cuff injury. However, previously published systematic reviews or meta-analyses still cast doubt on the efficacy of such concomitant procedures for postoperative patient function and pain recovery. In this study, we analyzed the effects of parameters such as shoulder function and acromion morphology on aged patients with full-thickness rotator cuff tear combined with rotator cuff injury treated with arthroscopic acromion plasty and rotator cuff repair. The results showed that arthroscopic acromion plasty and rotator cuff repair helped to promote the joint function recovery of the aged patients with full-thickness rotator cuff tear combined with rotator cuff injury and alleviate the pain of the patients. Compared with simple rotator cuff repair, this technique can increase the postoperative AT and reduce the ACEA and to some extent reduce the risk of postoperative rotator cuff reinjury, which is worthy of promotion.

Anterolateral Acromioplasty Does Not Change the Critical Shoulder Angle and Acromion Index in a Clinically Relevant Amount

Assessment on whether radiographic parameters of the acromion measured in radiographs change significantly after anterolateral acromioplasty. This retrospective study included patients that underwent an arthroscopic anterolateral acromioplasty between January 2014 and September 2020. n= 435 subjects with high-quality preoperative and postoperative radiographs according to Suter-Henninger criteria were included in the final assessment. All measurements were independently performed by the first and second author in a blinded fashion using dicomPACS software: acromion index (AI), critical shoulder angle (CSA), lateral acromial angle (LAA), beta angle, acromio-humeral distance (AHD), Aoki angle, frontal supraspinatus outlet angle (FSOW), and acromion type, according to Bigliani. SPSS software was used for statistical analysis. The beta angle and the CSA did not significantly change after operation (alpha power 0.32 and 0.11, respectively). In a subgroup analysis of patients with a pathological CSA >35° (n= 194), the CSA changed from 38.62 (range: 35.08-47.52, SD 2.83) to 38.04 (range: 29.18-48.12, SD 3.77) postoperatively (P= .028) (Fig 8). All other parameters changed significantly after operation (AI, AHD, FSOW, and Aoki; P= .001, LAA; P= .039) (Fig.9). The interobserver and intraobserver reliability was good to excellent in the majority of measured values. Mean patient age was 59.2 years (range: 18.1-87.1; SD 11.3), mean height was 1.73 meters (range: 1,50-1.98, SD 0.09), mean weight was 80.2 kg (range: 37.0-133.0, SD 16.68), and mean body mass index was 26.6 (range: 0.0-46.1, SD 4.73). Anterolateral acromioplasty producing a flat acromion undersurface did not result in a significant change of the CSA in the study population. Pathological preoperative CSA values of >35° were significantly reduced but not to normal values, but only by a small amount that puts the clinical relevance into question. IV, diagnostic study, case series.

Impingement Syndrome: A Review of the Literature

Rotator Cuff tendinopathy (RCT) is a common disorder that poses challenges for effective treatment. Evidence suggests that extrinsic, intrinsic, and combinations of biomechanical mechanisms play a role. There are no significant differences in outcome between conservatively and surgically treated patients with subacromial impingement syndrome (SAIS). For most patients with subacromial impingement syndrome (SAIS), nonsurgical treatment is successful. Surgical intervention is successful in patients who fail nonsurgical treatment. Surgeon experience and intraoperative assessment may guide the method of surgical treatment. Studies have shown that many surgical interventions, including debridement and open and arthroscopic acromioplasty, have been successful. However, there remains a need for high-quality clinical research on the diagnosis and treatment of SAIS. In this review, there are not figures and outcomes.

Does isolated arthroscopic anterior acromioplasty modify critical shoulder angle?

IntroductionCritical shoulder angle (CSA)>35° correlates significantly with primary rotator cuff tear and re-tear after repair. Acromial axial orientation varies between individuals. The present study aimed to assess the impact of strictly anterior acromioplasty on CSA. HypothesisCSA is reduced by arthroscopic anterior acromioplasty. Material and methodsA single-center retrospective study included patients receiving isolated arthroscopic acromioplasty between January 2016 and December 2017. Exclusion criteria comprised history of surgery and fracture or dislocation of the shoulder. Pre- and post-operative AP shoulder radiographs were taken. The angle subtended by a line between the inferior and superior edges of the glenoid and a line between the inferior edge of the glenoid and the most lateral point on the acromion was measured. ResultsOne hundred and two patients were included: mean age, 50.5±10.1 years (range, 23–82 years). Mean CSA was 34.7±4.4° (range, 26–48°) preoperatively and 31.7±3.7° (range, 23–40°) postoperatively (p<0.001). In the group with CSA >35°, the decrease was significant: 34.4±3.2° (range, 28–40°) versus 38.9±2.8° (range, 36–48°) (p<0.001), with 64% CSA <35° after isolated anterior acromioplasty. DiscussionCSA was decreased by arthroscopic acromioplasty. However, in 36% of cases with preoperative CSA >35°, CSA was not normalized. ConclusionAnterior arthroscopic acromioplasty significantly reduced CSA in the overall population, and especially in case of high CSA. Level of evidenceIV; retrospective study.

Short-Term Results of Patients Undergoing Arthroscopic Subacromial Decompression and Acromioplasty

Short-Term Results of Patients Undergoing Arthroscopic Subacromial Decompression and Acromioplasty

Influence of Radiographic Parameters on Reduction of the Critical Shoulder Angle With Arthroscopic Lateral Acromioplasty—A Mathematical Model

ObjectivesTo develop a mathematical model for the preoperative planning of arthroscopic lateral acromioplasty (ALA) and to evaluate the role of radiographic parameters with regards to the critical shoulder angle (CSA).MethodsAnteroposterior (AP) radiographs of patients who underwent rotator cuff surgery were screened to identify true AP radiographs. Radiographs were assessed for (1) native CSA, (2) CSA after simulated resection of a spur if present, (3) amount of ALA necessary to achieve a CSA of 34°, (4) CSA after 5-mm ALA, (5) lateral acromion angle, (6) acromion index, and (7) sclerosis of the greater tuberosity.ResultsA total of 1191 radiographs were screened. Of the 124 patients included, the native CSA was large (≥35°) in 56 patients (45%). In 30 patients (24%), a subacromial spur was detected and resection reduced the CSA by a median of 2°. Spur resection alone reduced the CSA to ≤34° in 19 patients (15.3%). Mean amount of ALA to achieve a CSA of 34° was 3.9 ± 1.8 mm, and this value strongly correlated with the CSA before ALA (R = 0.88, P < .001). The linear regression model to determine the amount of ALA to achieve a CSA of 34° was as follows: The multiple R2 for this model was 0.777. Mean reduction of CSA by 5-mm ALA was 3.8 ± 0.8° and 75% of large CSAs were reduced to a CSA of 30-34°. The acromion index had no significant independent influence on the model (P = .427), whereas lateral acromion angle was an independently significant predictor of required ALA to achieve a CSA of 34° (P = .019). Sclerosis of the greater tuberosity was significantly associated with a CSA of 35° or greater (P = .003).ConclusionsThe amount of ALA needed to reduce a large CSA to 34° correlates with the CSA before ALA and can preoperatively be planned with the use of a simple equation.Level of EvidenceLevel III; cross-sectional design; epidemiology study.

Lateral Acromioplasty has a Positive Impact on Rotator Cuff Repair in Patients with a Critical Shoulder Angle Greater than 35 Degrees.

Background: A Critical Shoulder Angle (CSA), evaluated on plain radiographs, greater than 35° is considered predictive of rotator cuff tears. The present prospective comparative study aimed, firstly, to develop a formula to calculate the amount of acromion that should be resected performing a lateral acromioplasty and, secondly, verify whether lateral acromioplasty to reduce the CSA associated with arthroscopic cuff repair decreased the rate of recurrence of the tears, and impacted favorably on clinical postoperative outcomes. Methods: Patients undergoing arthroscopic rotator cuff repair (RCR) for rotator cuff tears with a CSA greater than 35° were included in this study and divided into two groups, based on whether the CSA had been reduced by arthroscopic resection of the lateral portion of the acromion. A new mathematical formula was developed in order to quantify the amount of bone to be resected while performing the lateral acromioplasty. Patients with traumatic tears, previous surgery, osteoarthritis or plain radiographs, not classified as A1 according to Suter-Henninger, were excluded. Clinical and radiographic outcomes were assessed at a minimum of 2 years of follow-up considering the tear size. Results: 289 patients were included in this study. Thirty-seven were lost to follow-up. Group A (Lateral acromioplasty) patients included: 38 small tears, 30 medium tears, 28 large tears and 22 massive tears; Group B (control group) was composed of 40 small tears, 30 medium tears, 30 large tears and 23 massive tears. The Constants Score value and retear Rate were, respectively, significant higher (p = 0.007 and p = 0.004) and lower (p = 0.029 and p = 0.028) in Group A, both in the Small-and Medium-size subgroups. No complications were outlined. The mediolateral width of the acromion was reduced, according to the preoperatively calculated measure. Conclusion: Arthroscopic lateral acromioplasty decreased the CSA within the favorable range (30°–35°) in all patients treated, resecting the amount of bone predicted by the mathematical formula. Lateral acromioplasty is a safe and reproducible technique which may prevent recurrence of rotator cuff tears in patients with small and medium lesions. Level of evidence: II.

Effect of arthroscopic acromioplasty on reducing critical shoulder angle: a protocol for a prospective randomized clinical trial

BackgroundThe critical shoulder angle (CSA), which helps to predict patients who are at risk of rotator cuff tears (RCTs) with large degree and who are susceptible to osteoarthritis with low angle, has been identified as one of the most vital acromial parameters; anterolateral and lateral acromioplasties have been proven to be valid ways to reduce CSA. However, no study has compared the effect of different acromioplasties on the reduction of the large CSA (≥33°) clinically. Additionally, either anterolateral or lateral acromioplasty could not precisely correct large CSAs to a favorable range (30–33°) in each patient. Thus, we will propose a novel precise acromioplasty technique for the purpose of reducing CSA accurately and effectively, and compare the effectiveness of different acromioplasties on the reduction of the CSA.MethodsA total of 60 RCT patients who have indications for arthroscopic rotator cuff repair and with pre-operative CSA ≥33° will be recruited in outpatient center of Sun Yat-sen Memorial Hospital. Eligible participants will be randomly allocated to Group A (anterolateral acromioplasty), Group B (lateral acromioplasty) or Group C (precise acromioplasty) via a random, computer-generated number system. Three surgical plans will be made for each participant respectively by one professional surgeon according to the results of randomization allocation. The post-operative CSA will be measured 2 days post-operation. Follow-up will be maintained at 3, 6, and 12 months after surgery including the visual analog scale score, the University of California at Los Angeles score, the Constant Shoulder Score and the American Shoulder and Elbow Surgeon Shoulder Assessment Form. Finally, all outcomes will be assessed by two researchers who are blinded to the recruitment and allocation.DiscussionThis is the first clinical trial to evaluate the impact of different acromioplasties on the reduction of the CSA. Additionally, this study will provide a new precise acromioplasty technique, which is a novel precision and individualized treatment to prevent degenerative RCTs by reducing the CSA.Trial registrationChiCTR2000032343. Registered on April 26th, 2020.

Assessment of postoperative acromial and subacromial morphology after arthroscopic acromioplasty using magnetic resonance imaging.

To identify the morphological characteristics of the acromion and subacromial bursal space after arthroscopic acromioplasty using magnetic resonance imaging (MRI). One hundred patients who received arthroscopic rotator cuff repair and acromioplasty each received at least three MRI examinations (preoperative, first immediate postoperative, and second follow-up imaging between 8months and 1year postoperatively). Changes over time in the thickness and morphology of the postoperative acromion as well as the subacromial bursal space were assessed. Clinical and radiological parameters were also analyzed to identify any association with changes in acromial morphology. Despite minimal acromial thinning observed at the first immediate postoperative state, the acromions showed significant thinning at the second postoperative MRI, with a mean reduction of 32%. Along with acromial thinning, an exaggerated concave contour of the acromial undersurface was observed in some patients. In the subacromial space, a loculated fluid collection developed in 91% of the patients at the second postoperative follow-up. No statistically significant association was noted between postoperative acromial thickness change and clinical or radiological factors (P value > 0.05). A significant delayed reduction in acromial thickness within approximately 1year of arthroscopic acromioplasty is thought to be a normal postoperative feature. The simultaneous collection of a loculated, cyst-like fluid in the subacromial bursal space may be an important associated factor of postoperative acromial thinning.

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Critical shoulder angle (CSA) is the angle between glenoid inclination and the lateral edge of the acromion. CSA > 35° has been shown to be a risk factor for primary and iterative rotator cuff tendon tear. The present study aimed to assess change in CSA after anterior acromioplasty. The study hypothesis was that CSA is significantly reduced.A single-center retrospective descriptive observational study included patients undergoing open or arthroscopic anterior acromioplasty, with strict AP pre- and post-operative radiographs. Patients with radiographs not meeting Moor's criteria were excluded.One hundred and forty-eight patients were included: arthroscopy, 112; open surgery, 36. Mean age was 57.8 years (range, 29–80 years). Mean preoperative CSA was 36.1 ± 4.25° (range, 25–48.4°) and postoperative CSA 33.5 ± 3.9° (23.8–45.2°), for a significant reduction of −2.6 ± 2.5° (p = 0.001). Surgical technique did not affect change in CSA: open surgery, −2.3 ± 1.9° (−6.3° to −1°); arthroscopy, −2.7 ± 2.7° (−10.5° to −5°) (p = 0.06). In pathologic CSA (>35°), the mean reduction was −3.2 ± 2.6° (−10.5°to −5°). CSA normalized below the 35° threshold in 48% of patients.Despite reduction in CSA, the 35° threshold for iterative tear is not always reached after anterior acromioplasty. Complementary strictly lateral resection is theoretically required. However, change in CSA is difficult to predict intraoperatively.Anterior acromioplasty significantly reduced CSA, independently of technique and preoperative value.IV, retrospective descriptive study.

Does anterior acromioplasty reduce critical shoulder angle?

IntroductionCritical shoulder angle (CSA) is the angle between glenoid inclination and the lateral edge of the acromion. CSA>35° has been shown to be a risk factor for primary and iterative rotator cuff tendon tear. The present study aimed to assess change in CSA after anterior acromioplasty. The study hypothesis was that CSA is significantly reduced. MethodA single-center retrospective descriptive observational study included patients undergoing open or arthroscopic anterior acromioplasty, with strict AP pre- and post-operative radiographs. Patients with radiographs not meeting Moor's criteria were excluded. ResultsOne hundred and forty-eight patients were included: arthroscopy, 112; open surgery, 36. Mean age was 57.8 years (range, 29–80 years). Mean preoperative CSA was 36.1±4.25° (range, 25–48.4°) and postoperative CSA 33.5±3.9° (23.8–45.2°), for a significant reduction of −2.6±2.5° (p=0.001). Surgical technique did not affect change in CSA: open surgery, −2.3±1.9° (−6.3° to −1°); arthroscopy, −2.7±2.7° (−10.5° to −5°) (p=0.06). In pathologic CSA (>35°), the mean reduction was −3.2±2.6° (−10.5°to −5°). CSA normalized below the 35° threshold in 48% of patients. DiscussionDespite reduction in CSA, the 35° threshold for iterative tear is not always reached after anterior acromioplasty. Complementary strictly lateral resection is theoretically required. However, change in CSA is difficult to predict intraoperatively. ConclusionAnterior acromioplasty significantly reduced CSA, independently of technique and preoperative value. Level of evidenceIV, retrospective descriptive study.

Clinical and functional results of patients after arthroscopic single row rotator cuff repair and arthroscopic acromioplasty

Aim: The present study aims to evaluate clinical and functional results of arthroscopic single row rotator cuff repair and acromioplasty in patients with Rotator cuff tears (RCT). Materials and Methods: Sixty one patients whom were applied arthroscopic single row rotator cuff repair and arthroscopic acromioplasty between 2016 and 2019 were included in the present study. Patients’ rotator cuff tears (Patte classification) and acromion were classified based on X-ray and Magnetic Resonance Imaging (MRI) results. In addition, patients’ Constant Murley Scores, Shoulder Range of Motion (ROM) and visual analogue scale (VAS) scores were also analyzed prior to and following the surgical operation. Results: Forty one (67.2%) out of 61 patients in the present study were applied surgery on the right shoulders, while 20 of them (32.8%) were applied surgery on the left shoulders. Twenty one (34.4%) of patients were male, while 40 (65.6%) of them were female. Patients were divided into three groups as type 1 (n=10), type 2 (n=41), type 3 (n=10) based on their acromion classification and three stages as stage 1 (n= 15), stage 2 (n=36), and stage 3 (n=10) based on their rotator cuff tears. In addition, while their mean preoperative Constant-Murley and VAS scores were 29.8±0.79 and 9.14±0.11, respectively, it increased to 81.1±1.07 and decreased to 2.06±1.07 in the postoperative period, respectively. Finally, while patients’ preoperative mean abduction ROM was 60.73°±1.31°, it increased to 126.22°±2.27° in the postoperative period. Conclusion: Arthroscopic single row rotator cuff repair and arthroscopic acromioplasty in patients suffering from RCT contributes to significant relief of pain and remarkable increase in shoulder abduction ROM, thus offering an effective and reliable surgical treatment which allows the active use of extremities.

Radiofrequency microtenotomy: a promising method for treatment of rotator cuff tendinopathy.

Subacromial pain syndrome is a common disorder. Arthroscopic subacromial decompression is currently the preferred treatment method. Bipolar radiofrequency microtenotomy has shown promising results in treating tendinosis. In this study, the authors compare the results after arthroscopic acromioplasty with bipolar radiofrequency microtenotomy for patients with subacromial pain syndrome. A total of 27 patients, with subacromial pain syndrome, were followed for 2years. There were 14 patients in the arthroscopic acromioplasty group and 13 patients in the radiofrequency microtenotomy group. Clinical outcome data included pain reported using a visual analog scale, Constant score, and strength. Magnetic resonance imaging of the affected shoulder was performed before and 2years after intervention for an evaluation of the tendinosis grade. All patients attended the final follow-up 2years after intervention. No significant differences were found at baseline between the groups. Pain measured by the visual analog scale revealed a significant reduction in both groups at 12weeks, 6months and 2years compared with baseline. There was no significant difference between the groups in terms of visual analog scale, Constant score, or strength. The magnetic resonance imaging revealed a significant improvement in the tendinosis score in both groups, without any significant difference between the groups. In this prospective randomized study, the clinical assessments revealed a significant improvement in terms of the visual analog scale, strength, Constant score, and tendinosis score 2years after intervention with either arthroscopic acromioplasty or radiofrequency microtenotomy in patients with subacromial pain syndrome. However, no significant differences were found between the groups. This study reveals that there are surgical options other than acromioplasty in patients with SAPS. II.