Effect of arthroscopic subacromial decompression during arthroscopic repair of small to medium-sized rotator cuff tears

Kenta Inagaki; Nobuyasu Ochiai; Yu Hiraoka; Shohei Ise; Yohei Shimada; Naoya Hirosawa; Eiko Hashimoto; Seiji Ohtori

doi:10.1016/j.jseint.2022.11.004

Effect of arthroscopic subacromial decompression during arthroscopic repair of small to medium-sized rotator cuff tears

JSES Int. 2022 Dec 15;7(2):296-300. doi: 10.1016/j.jseint.2022.11.004. eCollection 2023 Mar.

Authors

Kenta Inagaki¹, Nobuyasu Ochiai¹, Yu Hiraoka¹, Shohei Ise¹, Yohei Shimada¹, Naoya Hirosawa¹, Eiko Hashimoto¹, Seiji Ohtori¹

Affiliation

¹ Department of Orthopaedic Surgery, Chiba University Hospital, Chiba-city, Chiba, Japan.

Abstract

Background: Although arthroscopic subacromial decompression (ASD) is a commonly used procedure during arthroscopic rotator cuff repair (ARCR), the effect of ASD on the clinical outcomes for ARCR is controversial. The purpose of this study was to compare the clinical outcomes of ARCR with or without ASD.

Methods: Patients (n = 315 with 320 shoulders) who underwent ARCR for small to medium-sized rotator cuff tears were followed for at least 24 months. ARCR was performed with ASD (180 shoulders, group A) or without ASD (140 shoulders, group N). There were no significant differences in patient demographics, including mean age and mean follow-up time. Rotator cuff repair was performed using the suture-bridge technique in all shoulders, and all patients were treated using the same rehabilitation protocol after surgery. University of California at Los Angeles score, Constant score, re-tear rates, revision surgery rates, and operating time were compared between groups. Re-tear was defined as Sugaya classification Types 4 and 5 using postoperative magnetic resonance imaging at more than 12 months.

Results: There was no statistically significant difference in clinical outcomes before and after ARCR between groups. However, the University of California at Los Angeles scores and Constant scores significantly improved in both groups after surgery (P < .001). Furthermore, there was no major difference in the re-tear rates between groups A (7/180 shoulders, 3.9%) and N (11/140 shoulders, 7.9%) (P = .146). Revision surgeries were performed on 3/180 shoulders (1.7%) in group A (due to postoperative deep infection in one shoulder and revision ARCR for re-tear in two shoulders). No revisions surgeries were needed in group N patients (P = .259). The mean surgical time for group A was 62.0 ± 27.0 minutes (29-138 min.) and 52.4 ± 26.1 minutes (17-124 min.) for group N (P = .007).

Conclusion: These results suggest that ASD has a limited effect on clinical outcomes of ARCR for small to medium-sized rotator cuff tears.

Keywords: Acromial index; Acromial type; Arthroscopic rotator cuff repair; Arthroscopic subacromial decompression; Critical shoulder angle; Rotator cuff re-tear; Rotator cuff tear.