Comparison of open and arthroscopic subacromial decompression

We retrospectively reviewed 68 patients (70 shoulders) who underwent either open or arthroscopic acromioplasty performed by a single surgeon (JPI) for chronic impingement syndrome in the presence of an intact rotator cuff. Group 1 consisted of 24 shoulders that had open acromioplasty and group 2 consisted of 46 shoulders that had arthroscopic acromioplasty. The minimum follow-up was 12 months for both groups. There was no statistical difference in mean postoperative shoulder scores between the operative groups. However, there were more excellent results in the open group as compared with the arthroscopic group (54.2% vs 41.9%, respectively). In addition, there was a higher percentage of poor results in group 2 as compared with group 1 (27.9% vs 16.6%, respectively). Arthroscopic acromioplasty was associated with shorter hospital stays and faster achievement of maximal pain relief as compared with open acromioplasty. Examination of postoperative radiographs often revealed subacromial calcifications. These calcifications were more frequent after arthroscopic acromioplasty and were associated with a worse result.