The Role of Acromioplasty for Management of Rotator Cuff Problems: Where Is the Evidence?

Table 1

Summary of prospective randomized controlled trials studying the role of acromioplasty in treatment of rotator cuff disease.

Author	Journal/year	Inclusion criteria	Patients/age	Follow up rate and length	Randomization	Measured outcomes	Primary result	Secondary result
Henkus et al. [26]	JBJS-B; 2009	Subacromial impingement syndrome	57 pts; mean age 47	56/57; (98%); 30 months	26 bursectomy only; 30 bursectomy w/acromioplasty	Constant, SST, pain VAS	No difference	Acromion morphology made no difference in outcome
Shin et al. [27]	Arthroscopy; 2012	Small-to medium-sized rotator cuff tears	150 pts; mean age 56.8	120/150; (80%); 35 months	60 in ARCR-A; 60 in ARCR	Constant, ASES, UCLA, pain VAS	No difference	Acromion morphology made no difference in outcome; retear rates (MRI): 17% ARCR-A versus 20% ARCR (𝑃=0.48)
MacDonald et al. [28]	JBJS-A; 2011	Full-thickness cuff tears;	86 pts; mean age 56.8	68/86; (79%); 24 months	32 in ARCR-A; 36 in ARCR	WORC, ASES	No difference	Revision rate: 0/32 ARCR-A versus 4/36 in ARCR (𝑃=0.05)
Milano et al. [29]	Arthroscopy; 2007	Full-thickness cuff tears; type 2 and 3 acromions	80 pts; mean age 60.4	71/80; (89%); 24 months	34 in ARCR-A; 37 in ARCR	Constant, DASH, work-DASH	No difference
Gartsman and O’Connor [30]	JSES; 2004	Full-thickness supraspinatus tear, type 2 acromion	93 pts; mean age 59.7	93/93; (100%); 15.6 months	47 in ARCR-A; 46 in ARCR	ASES	No difference

ARCR-A: arthroscopic rotator cuff repair with bursectomy and acromioplasty; ARCR: arthroscopic rotator cuff repair with bursectomy only; SST: Simple Shoulder Test score; VAS: visual analog score; UCLA: University of California Los Angeles Shoulder score; WORC: Western Ontario Rotator Cuff index; ASES: American Shoulder and Elbow Society shoulder score; DASH: disability of arm, shoulder and hand score.