7th July 2017, Volume 130 Number 1458

Elizabeth C Bond, Anthony Maher, Lynette Hunt, Warren Leigh, Matthew Brick, Simon W Young, Michael Caughey

The concept of acromioplasty aiming to reduce extrinsic mechanical impingement was introduced by Dr Neer in 1972,1 however, the exact role of acromioplasty when repairing rotator cuff tears remains unclear.…

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Summary

This paper looks at whether or not acromioplasty (a decompression procedure) makes a difference in pain and functional outcome after repair of the rotator cuff tendons in the shoulder—a commonly performed procedure. We found no difference at 24 months regardless of whether or not acromioplasty was undertaken.

Abstract

Aim

The role of acromioplasty with rotator cuff repair remains unclear. This study aims to test the null hypothesis—that acromioplasty in conjunction with rotator cuff repair has no effect on improvement in pain or shoulder function at two years follow up.

Method

Data was obtained from a collaborative nationwide project between March 2009 and December 2010, and consisted of a total of 2,441 patients undergoing primary repair of superior rotator cuff tears. Multivariate analysis was performed to assess the effect of the inclusion of acromioplasty at the time of rotator cuff repair on visual analogue scale (VAS) pain scores and Flex Shoulder Function (Flex SF) scores at 24-month follow up.

Results

On univariate analysis there was a significantly higher Flex SF score in the acromioplasty group (40.5) compared to the no acromioplasty group (38.7) and a lower mean pain score at 24 months in the acromioplasty group (1.44 vs 1.74). There was a significant difference in tear area and surgical repair technique between the two groups. On multivariate analysis there was no statistically significant difference in Flex SF or VAS pain scores between the two groups.

Conclusion

There was no difference in pain or function scores at two years following rotator cuff repair regardless of whether or not acromioplasty was performed. This paper represents the largest study to date comparing acromioplasty to no acromioplasty in the setting of cuff repair. It supports previous literature in showing no significant difference in pain or shoulder function between the two groups.

Author Information

Elizabeth C Bond, Orthopaedic Trainee, Wellington Hospital; Anthony Maher, Orthopaedic Trainee, Hawkes Bay Hospital; Lynette Hunt, Statistician, Waikato University; Warren Leigh, Orthopaedic Surgeon, Orthosports North Shore; Matthew Brick, Orthopaedic Surgeon, Orthosports North Shore; Simon W Young, Orthopaedic Surgeon, North Shore Hospital; Michael Caughey, Orthopaedic Surgeon, Auckland Surgical Centre.

Acknowledgements

No outside funding source was involved in the data collection, data analysis or the preparation or editing of this study. The New Zealand Rotator Cuff Registry is a charitable trust which has received funding from a number of sources. The authors wish to acknowledge the Accident Compensation Commision research grant which provided the majority of the funding. We also wish to acknowledge funding from the New Zealand Shoulder and Elbow Society, The New Zealand Orthopaedic Association Trust, The Wishbone Trust, Device Technologies, Johnson & Johnson and Smith & Nephew.

Correspondence

Dr Elizabeth Bond, c/o Orthopaedic Department, Wellington Regional Hospital, Private Bag 7902, Wellington 6242.

Correspondence Email

elizabeth.bond@ccdhb.org.nz

Competing Interests

Nil.

References

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