Patients With Impingement Syndrome With and Without Rotator Cuff Tears Do Well 20 Years After Arthroscopic Subacromial Decompression

Arthroscopy. 2016 Mar;32(3):409-15. doi: 10.1016/j.arthro.2015.08.026. Epub 2015 Oct 24.

Abstract

Purpose: To present the long-term outcome of arthroscopic subacromial decompression (ASD) for patients with impingement syndrome with or without rotator cuff tears as well as with or without calcific tendinitis in a follow-up of 20 years.

Methods: We included 95 patients after a mean follow-up of 19.9 (19.5 to 20.5) years. All patients underwent ASD, including acromioplasty, resection of the coracoacromial ligament, and coplaning without cuff repair. The Constant score was used to assess the functioning of the shoulder. In addition, we defined a combined failure end point of a poor Constant score and revision surgery.

Results: Revision surgery was performed in14.7% of the patients. The combined end point showed successful results in 78.8% of all cases. All patients with isolated impingement syndrome achieved successful results. Those with partial-thickness tears had successful outcomes in 90.9% of all cases, and patients with full-thickness tears had successful outcomes in 70.6% of all cases. The tendinitis calcarea group showed the poorest results, with a 65.2% success rate.

Conclusions: Our long-term results show that patients with impingement syndrome who received ASD, including acromioplasty, resection of the coracoacromial ligament, and coplaning do well 20 years after the index surgery. ASD without cuff repair even appears to be a safe, efficacious, and sustainable procedure for patients with partial rotator cuff tears.

Level of evidence: Level IV, therapeutic case series.

MeSH terms

  • Acromion / surgery*
  • Adult
  • Arthroplasty / methods*
  • Arthroscopy / methods*
  • Bursa, Synovial / surgery
  • Decompression, Surgical / methods*
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Ligaments, Articular / surgery
  • Male
  • Middle Aged
  • Postoperative Period
  • Retrospective Studies
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries*
  • Shoulder / surgery
  • Shoulder Impingement Syndrome / diagnosis
  • Shoulder Impingement Syndrome / surgery*
  • Shoulder Joint / surgery
  • Treatment Outcome