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Comparison of open and arthroscopic subacromial decompression
M D Lazarus1, H A Chansky, S Misra
1From the Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Penn.; McKay Laboratory of Orthopaedic Research, University of Pennsylvania, School of Medicine, Philadelphia, Penn.
Open acromioplasty showed more excellent results for chronic impingement syndrome compared to arthroscopic acromioplasty, despite similar overall scores. Arthroscopic surgery led to shorter hospital stays but more poor outcomes and subacromial calcifications.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Surgery
Background:
- Chronic impingement syndrome affects rotator cuff integrity.
- Acromioplasty is a surgical option for impingement syndrome.
- Open and arthroscopic techniques exist for acromioplasty.
Purpose of the Study:
- To compare outcomes of open versus arthroscopic acromioplasty for chronic impingement syndrome.
- To evaluate the impact of subacromial calcifications on surgical results.
Main Methods:
- Retrospective review of 68 patients (70 shoulders) undergoing acromioplasty by a single surgeon.
- Comparison of open acromioplasty (24 shoulders) and arthroscopic acromioplasty (46 shoulders).
- Minimum 12-month follow-up assessing shoulder scores and radiographic findings.
Main Results:
- No statistical difference in mean postoperative shoulder scores between groups.
- Open acromioplasty yielded a higher percentage of excellent results (54.2% vs 41.9%).
- Arthroscopic acromioplasty had a higher percentage of poor results (27.9% vs 16.6%) and more subacromial calcifications, associated with worse outcomes.
Conclusions:
- Open acromioplasty may offer superior outcomes for chronic impingement syndrome despite similar average scores.
- Subacromial calcifications post-arthroscopic acromioplasty correlate with poorer results.
- While arthroscopic surgery offers faster recovery, open surgery may provide better long-term results in select cases.
