Rotator cuff repair without acromioplasty associated with increased reoperation rates
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Results showed patients who underwent rotator cuff repair without acromioplasty had increased reoperation rates compared with patients who underwent the procedure with acromioplasty.
In a two-part study from 2003 to 2011 and 2015 to 2021, researchers randomly assigned 45 patients to undergo rotator cuff repair without acromioplasty and 41 patients to undergo rotator cuff repair with acromioplasty for full-thickness rotator cuff tears. Mean follow-up was 11.2 years in the 31 patients without acromioplasty and 11.5 years in the 25 patients with acromioplasty who had complete long-term outcomes. Primary outcome measures included reoperation rates and patient-report outcomes such as the Western Ontario Rotator Cuff (WORC) index.
Overall, researchers found no significant differences in WORC scores between the cohorts preoperatively to final follow-up. Patients without acromioplasty had a preoperative WORC score of 33.1 and long-term WORC score of 76.1, while patients with acromioplasty had a preoperative WORC score of 38.6 and long-term WORC score of 82.2. According to the study, 16% of patients (n = 7) without acromioplasty and 2% of patients (n = 1) with acromioplasty underwent reoperation. Researchers noted all patients who underwent reoperation had a type-2 or type-3 acromion.
“Performing an acromioplasty may have provided a protective effect on the rotator cuff repair in patients with an amorphous acromion (type-2 or type-3), and this effect may have been cumulative, with increasing failures over time from the index surgical procedure,” the researchers wrote in the study.
Editor's Note: This article was updated on Nov. 17, 2022 to more accurately reflect the reoperation rates in the study.
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