[Arthroscopic subacromial decompression--indications in os acromiale?]

A total of 122 patients with subacromial pathology without tears in the rotator cuff underwent arthroscopic subacromial decompression (ASD) and were re-examined 1-3 years after the operation. All patients' data were recorded before and after operation with reference to a 100-point shoulder score. The group included 12 patients who proved to have an os acromiale on X-ray. Postoperatively scores wee significantly higher (p < 0.05). Patients with os acromiale had a slightly but not significantly worse outcome than the others. Results were excellent in 43% of all patients, good in 17%, and fair in 25%, while 15% were considered failures. Again patients with an os acromiale had a slightly, but not significantly, worse result. Patients with a preoperative pain history of more than 1 year had a significantly worse result than those with a preoperative course of less than 1 year (p < 0.05). This was true for both groups without any differences between them. Older patients also scored worse in both groups. Other factors, e.g. sex, preoperative range of motion, and muscle atrophy, did not significantly influence the result. Our results after ASD in patients with subacromial pathology without rupture of the rotator cuff and with os acromiale are encouraging. Therefore, this minimally invasive procedure seems to be a reasonable alternative to other complex procedures with ORIF in selected cases.