William R. Beach, MD, Mark A. Frankle, MD, Mark H. Getelman, MD, John E. (Jed) Kuhn, MD, MS, Matthew T. Provencher, MD, CPAT, MC, USNR(Ret.)
Surgeons have performed acromioplasty to reduce pain and prevent rotator cuff disease progression since the 1970s. However, in the past decade, a number of randomized trials have brought the appropriate use of acromioplasty into question.
“There is certainly evidence out there that would suggest routine acromioplasty is not always indicated in subacromial disease patterns and/or with concomitant rotator cuff surgery,” Matthew T. Provencher, MD, CPAT, MC, USNR (Ret.), professor of surgery and orthopedics at Uniformed Services University of the Health Sciences and shoulder, knee and sports surgeon at the Steadman Clinic, told Orthopedics Today. “Whether they have been randomized trials or pooled data studies, such as systematic reviews, they have not shown a clinically significant benefit. Although some of them did show improvement in overall outcome scores, the benefit was felt not to be clinically meaningful or significant.” However, there are certainly some cases where acromioplasty is clearly indicated.
Due to this increasing evidence, in 2010, the American Academy of Orthopaedic Surgeons released clinical practice guidelines on the management of rotator cuff injuries that included moderate strength evidence that did not require routine acromioplasty at the time of rotator cuff repair. Updated in 2019, the current clinical practice guidelines provide moderate strength evidence that does not support the routine use of acromioplasty as concomitant treatment for small – to medium-sized full-thickness rotator cuff tears compared with arthroscopic repair alone.
You may read the full article: Acromioplasty: Not a one-size-fits-all procedure