The shoulder impingement syndrome: The results of surgical decompression

Forty patients (41 operated shoulders) with subacromial impingement resistant to conservative therapy underwent acomioplasty and were evaluated 6 to 142 months after surgery. Patients requiring rotator cuff repair were excluded from the study. With the UCLA scoring system, results were excellent or good in 28 (68%), fair in five (12%), and poor in eight (20%). Thirty-three (80%) were satisfied with their result. There was a trend toward poorer results in women and in the elderly (aged 60 to 69 years). A striking finding was the statistically significant relationship between result rating and duration of symptoms. Ninety-three percent had an excellent or good result, if they had been symptomatic for greater than 3 years, whereas only 56% reached those ratings with symptom duration less than 3 years. The only complication was a superficial infection. Three patients required manipulation after the procedure. Two required subsequent surgery because of continuing pain. This procedure seems safe and reasonably effective. Careful patient selection must be stressed. Results will be better with a longer preoperative duration of symptoms.