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Failed subacromial decompression. Risk factors.

A Bouchard1, J Garret2, L Favard3

  • 1Hôpital d'Instruction des Armées Bégin Saint-Mandé, 69, avenue de Paris, 94160 Saint-Mandé, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|December 3, 2014
PubMed
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Isolated arthroscopic subacromial decompression (acromioplasty) has a 29% failure rate. Workers' compensation and co-planing are significant predictors of persistent shoulder pain after acromioplasty.

Area of Science:

  • Orthopedic surgery
  • Shoulder arthroscopy
  • Pain management

Background:

  • Arthroscopic subacromial decompression (acromioplasty) is a common procedure for shoulder pain.
  • However, persistent pain after acromioplasty remains a clinical challenge.
  • Identifying factors predicting treatment failure is crucial for patient outcomes.

Purpose of the Study:

  • To determine the failure rate of isolated arthroscopic subacromial decompression.
  • To identify predictors of persistent pain following the procedure.

Main Methods:

  • Retrospective multicenter study of 108 patients undergoing isolated arthroscopic subacromial decompression (2007-2011).
  • Exclusion of patients with concomitant rotator cuff procedures.
  • Data collected via medical records, questionnaires, and radiographs.
Keywords:
Arthroscopic subacromial decompressionSubacromial impingement syndromeTreatment failure

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  • Failure defined as VAS score >3 at >6 months post-surgery.

    • Main Results:

    • The overall failure rate was 29% (31/108 patients).
    • Workers' compensation benefits and co-planing were significant predictors of failure.
    • Calcific tendinopathy and partial rotator cuff tears showed trends toward poorer outcomes but were not statistically significant.

    Conclusions:

    • Isolated arthroscopic subacromial decompression is effective in approximately 70% of cases.
    • Caution is advised for patients receiving workers' compensation or undergoing co-planing due to increased failure risk.
    • Acromioclavicular resection may be a better option for acromioclavicular joint symptoms.