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Arthroscopic versus open acromioplasty: a prospective, randomized, blinded study
Mark J Spangehl1, Robert H Hawkins, Robert G McCormack
1Department of Orthopaedics, University of British Columbia, Vancouver, Canada.
Journal of Shoulder and Elbow Surgery
|May 4, 2002
Summary
This study compared open versus arthroscopic acromioplasty for impingement syndrome. Open acromioplasty showed superiority in pain and function outcomes, though both methods offered significant improvement.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Arthroscopy
Background:
- Impingement syndrome is a common cause of shoulder pain.
- Acromioplasty is a surgical procedure to relieve impingement.
- Arthroscopic and open techniques exist, with varying outcomes.
Purpose of the Study:
- To compare the efficacy and superiority of arthroscopic acromioplasty versus open acromioplasty.
- To evaluate patient outcomes in a prospective, randomized, controlled, blinded clinical trial.
Main Methods:
- Randomized controlled trial involving 62 patients with impingement syndrome.
- Stratification based on age, ligamentous laxity, and compensation claims.
- Outcomes measured by visual analog scales (VAS) for pain and function, UCLA shoulder scores, and patient satisfaction.
Main Results:
- No significant differences in postoperative improvement, patient satisfaction, UCLA scores, or strength between the two groups.
- Open acromioplasty demonstrated superiority for pain and function (P =.01).
- Overall good/excellent results were 67%, increasing to 87% when compensation claims were excluded.
Conclusions:
- Open acromioplasty may be superior to arthroscopic acromioplasty for pain and function in impingement syndrome.
- Both techniques provide significant improvement, but patient satisfaction and UCLA scores were comparable.
- Unsettled compensation claims are a predictor of poor surgical outcomes.