Arthroscopic acromioplasty for the treatment of impingement syndrome of shoulder

Objective To explore the methods and clinical results of the arthroscopic acromioplasty for the treatment of impingement syndrome of shoulder. Methods 15 cases with impingement syndrome of shoulder were studied. There were 9 males and 6 females. 10 right shoulders and 5 left ones were involved. The average age of patients was 47 years ranging from 32 to 54 years. 3 injuries were classified as degree I, 4 as Ⅱ, and 8 as Ⅲ according to Neer classification. All the patients had a chronic injury and painful history around shoulder. The positive arch pain test was presented in 12 cases and impingement test in 13 cases. 13 patients had been received MR examinations, and 5 arthrographies of the shoulder. The AP and the supraspinatus outlet projection of the X-rays were obtained before surgery. The procedure of arthroscopic acromioplasty consisted of 5 following steps: the first was arthroscopic subacromial inspection with posterior portal; the second was subacromial bursectomy with electro-shaver or burr; the third was release or resection of the coracoacromial ligament with electrocautery; the fourth was subacromial decompression with full-radius resector or burr; and the last was debridement of the soft tissue around the acromio-clavicular joint and resection of the the spurs. 4 patients underwent reparation of the rotator cuff simultaneously. Results All cases were available for follow-up. The average time was 15 months. According to the UCLA scoring system, the average score was 18.5±8.2 and 31.7±6.5 pre- and post-operation respectively; the difference was of statistical significance(t=3.35, P0.05). The results were 8 excellent, 4 good, 2 fair and 1 poor. Conclusion Impingement is the common cause for the pain and dysfunction of the shoulder, the arthroscopic acromioplasty is a reliable solution. This surgery has many advantages, such as mini-invasion, rapid recovery and early rehabilitation.