The Effect of Acromioplasty or Bursectomy on the Results of Arthroscopic Repair of Full Thickness Rotator Cuff Tears: does the acromion type affect these results?

of Full Thickness Rotator Cuff Tears: Does the Acromion Type Affect These Results? S houlder pain is described as the second most common musculoskeletal system disorder following lower back pain.Rotator cuff pathology and subacromial impingement are accepted as the leading causes of shoulder pain.[1] Rotator cuff pathologies include partial or full thickness rotator cuff tears, subacromial bursitis, or rotator cuff tendinitis.Subacromial impingement syndrome has been ac-cepted for many years as the most common reason for rotator cuff pathology.In 1949, Armstrong [2] first suggested that the impingement of bursa and rotator cuff tendons below the acromion caused supraspinatus syndrome.Neer later reported that 95% of rotator cuff tears were due to mechanical impingement and treatment was successful with partial anterior acromioplasty.[3,4] Objectives: The aim of this study was to investigate the effect of subacromial decompression on the results of full thickness rotator cuff repair applied arthroscopically.Examination was also made of the effect of acromion type on the subacromial decompression procedure in patients applied with arthroscopic rotator cuff repair. Methods:The study included a total of 150 patients, comprising 102 (68%) females and 48 (32%) males with a full thickness rotator cuff tear repaired arthroscopically.The patients were separated into three groups of 50.Group A comprised those with acromioplasty and bursectomy applied additional to the repair.In Group B, only bursectomy was performed additional to the repair and in Group C, only rotator cuff repair was applied.Evaluation was made of the post-operative long-term pain and functional results.Results: The mean age of the cases was 65.63±9.22years (range, 46-86 years).The affected side was right side in 95 (63.3%) cases and left side in 55 (36.7%).No statistically significant difference was determined between the groups according to the post-operative Constant Murley and ASES scores (p>0.05).In the paired comparisons, the post-operative VAS scores of Group C were higher than those of Groups A and B (p=0.018, p=0.029, p<0.05).No statistically significant difference was determined between Group A and Group B in respect of the post-operative VAS scores (p>0.05).Conclusion: In the arthroscopic repair of full thickness rotator cuff tears, neither acromioplasty, coracoacromial ligament loosening nor bursectomy were determined to have any positive effect on the results.Whatever the acromion type, there is no need for an additional subacromial decompression procedure after rotator cuff repair, in respect of pain and functional outcomes.Only acromial spurs should be gently removed paying attention to the coraco-acromial ligament.