Reconstruction of the deltoid and acromion after failed acromionectomy

Ten patients who had reconstruction of the acromion and deltoid in a painful dysfunctional shoulder after an acromionectomy were reviewed with respect to pain, range of motion, strength, patients' satisfaction, and complications. There were four total acromionectomies, five subtotal acromionectomies, and one partial acromionectomy. The retracted deltoid and defect of the bony acromion were reconstructed with a composite graft consisting of tricortical iliac bone with fascia lata. At an average followup of 58 months, the mean active forward flexion improved from 53 degrees to 122 degrees. All patients reported considerable relief of pain and three had no pain; however, the patients who had a supplementary cuff repair had poor results. The average UCLA score of the patients improved from 6.6 to 26.3. The score of the patients with intact rotator cuffs improved from 7.0 to 32.0, whereas patients who had rotator cuff tears had scores that improved from 6.2 to 20.4. Our clinical results suggest that reconstruction of the acromion and deltoid using an iliac bone graft and fascia in failed acromionectomy can lead to relief of pain and the improvement of shoulder function.

Therapeutic study, Level IV (case series-no, or historical control group).