Abstract
Purpose
To evaluate the effect of acromioplasty using a cutting block technique on bony coverage as measured by the critical shoulder angle (CSA) and acromial index (AI).
Methods
This study is a retrospective radiographic review using data from a previous prospective randomized clinical trial that offered enrollment to patients aged 18 years or older with a full‐thickness tear of the superior rotator cuff between October 2007 and January 2011. Each patient was allocated to repair with either acromioplasty using a cutting block technique or non‐acromioplasty treatment arms in a blinded fashion. Medical and demographic information was recorded for each patient. Between January 2017 and December 2017, patients were contacted for repeat follow‐up clinical evaluation and radiographs. Measurements of acromial index and critical shoulder angle were performed on pre‐ and postoperative radiographs by a single reviewer.
Results
Seventy‐one (75%) patients were available for follow up. The 2 groups were similar in terms of baseline demographics and acromial type. When compared with preoperative measures, acromioplasty did not result in significant reductions in mean CSA (34.5° vs 35.5°;
P
= .293) or AI (0.68 vs 0.66;
P
= .283). Furthermore, postoperative CSA (34.5° vs 36.2°,
P
= .052) and AI (0.66 vs 0.67,
P
= .535) demonstrated no statistically significant differences between patients with and without acromioplasty, respectively.
Conclusions
There was no statistically significant change in either the CSA or AI following acromioplasty, nor was there a significant postoperative difference in CSA or AI between the group that underwent acromioplasty and the group that did not.
Clinical Relevance
Some studies suggest a greater postoperative CSA may result in greater risk of retear after arthroscopic rotator cuff repair. The CSA and AI may not be modifiable with acromioplasty.