Clinical outcome of arthroscopic acromioplasty vs. arthroscopic rotator cuff repair for irreparable rotator cuff tears: A3-year follow-up.

BACKGROUND: Rotator cuff tendon tears at the shoulder joint are one of the most common causes of shoulder discomfort and impairment.

OBJECTIVE: This study aims to compare the long-term patient-reported outcomes of arthroscopic acromioplasty to arthroscopic rotator cuff repair.

METHODS: Patients who underwent arthroscopic repair for irreparable rotator cuff tears between January 1 and December 1, 2022, and had any morphology of the acromial bone were randomly assigned to either the arthroscopic acromioplasty or arthroscopic rotator cuff repair groups. Excluded from the study were patients who had undergone revision surgery, had subscapularis involvement, had severe neurologic diseases, or had passed away. Baseline and long-term follow-up surveys collected scores from the American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), University of California-Los Angeles (UCLA), Visual Analog Scale (VAS) for Pain, and consistent scores. Averages were calculated after adjusting for standard deviation.

RESULTS: In the first trial, 30 patients from Group A (arthroscopic acromioplasty) and 30 patients from Group B (arthroscopic rotator cuff repair) underwent long-term follow-up. The average age of patients in Group A was 58.62 ± 5.95 years, while in Group B it was 59.11 ± 7.98 years. At the final follow-up, there were no statistically significant differences between Group A and Group B patients for ASES (P= 0.233), VAS pain (P= 0.154), Constant (P= 0.584), or SST (P= 0.155). However, Group A showed statistically significant improvements compared to Group B at the 2-year postoperative follow-up for UCLA (P= 0.015) and SF-12 (P= 0.021). Additionally, in the short-term results, Group A outperformed Group B significantly in forward flexion (P< 0.05), abduction (P< 0.05), and external rotation in abduction (P< 0.05).

CONCLUSION: Our study revealed that acromioplasty alone was superior to rotator cuff repair in terms of patient assessments of shoulder mobility and discomfort.