Acromioplasty: A Historical Perspective

In patients with shoulder impingement syndrome unresponsive to nonoperative treatment, surgical management is often recommended. This historical review goes into depth on how through research, evidence, and modern technologies, the surgical technique can evolve over time.

This study aims to provide a review of the literature comparing outcomes of arthroscopic versus open acromioplasty and discuss how the evidence influences surgical techniques and surgeons' modern day preferences.

Following PRISMA reporting standards, Medline, Embase (OVID), Web of Science, Pubmed, and Cochrane were searched through October 2024 for studies comparing arthroscopic and open acromioplasty for shoulder impingement syndromes. Outcomes of interest included operating time, hospital stay, range of motion, muscle strength, patient satisfaction, and UCLA shoulder score.

Seventeen studies evaluated 1,293 patients (763 males and 530 females) with a mean age of 45.4 years old, who underwent either arthroscopic or open acromioplasty. Both groups showed similar improvements in range of motion, muscle strength, and patient satisfaction. Patients who underwent arthroscopic acromioplasty had quicker recovery and shorter hospital stays, with reduced operative times when performed by experienced surgeons. Outcome scores (UCLA and Constant scores) were generally higher in the arthroscopic group; however, the results were not always statistically significant.

Over time, the standard of care has shifted to arthroscopic acromioplasty as it offers better recovery times and improved cosmetic results, making it the favored approach for shoulder impingement syndromes in patients and surgeons alike. Through continued research and surgical innovation surgical techniques can evolve and ultimately improve patient care.