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

J Jerosch1, J Steinbeck, J M Strauss

  • 1Klinik und Poliklinik für Allgenmeine Orthopädie, Westfälischen Wilhelms-Universität Münster.

Der Unfallchirurg
|February 1, 1994
PubMed
Summary

Arthroscopic subacromial decompression (ASD) offers encouraging results for patients with subacromial pathology. This minimally invasive surgery is a viable alternative for selected cases, even those with os acromiale.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Arthroscopy

Background:

  • Subacromial pathology without rotator cuff tears is a common cause of shoulder pain.
  • Arthroscopic subacromial decompression (ASD) is a frequently performed minimally invasive procedure.
  • The presence of os acromiale may influence surgical outcomes.

Purpose of the Study:

  • To evaluate the outcomes of arthroscopic subacromial decompression (ASD) in patients with subacromial pathology without rotator cuff tears.
  • To assess the impact of os acromiale on ASD outcomes.
  • To identify factors influencing patient success after ASD.

Main Methods:

  • A cohort of 122 patients with subacromial pathology (without rotator cuff tears) underwent ASD.
  • Patient data, including a 100-point shoulder score, were collected preoperatively and 1-3 years postoperatively.

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  • A subgroup of 12 patients with os acromiale was analyzed separately.

    • Main Results:

    • Postoperative shoulder scores significantly improved (p < 0.05).
    • Overall success rates were: 43% excellent, 17% good, 25% fair, and 15% failures.
    • Patients with os acromiale or preoperative pain >1 year reported significantly worse outcomes.

    Conclusions:

    • ASD is an effective treatment for subacromial pathology without rotator cuff tears, yielding encouraging results.
    • Os acromiale and prolonged preoperative pain may negatively impact outcomes but do not preclude successful treatment.
    • ASD represents a reasonable, minimally invasive alternative to open procedures in selected patients.