Guidelines from the Washington State Department of Labor and Industry state that patients who should undergo isolated subacromial decompression (with or without acromioplasty
) need to have documented subacromial impingement syndrome with magnetic resonance imaging evidence of rotator cuff tendonopathy or tear, have undergone 12 weeks of conservative therapy (including at least active assisted range of motion and home-based exercises), and have had a subacromial injection with a local anesthetic that has provided documented relief of pain.
Performing the arthroscopic acromioplasty
and clavicle resection rotator cuff repair is indicated in shoulders with complete rotator cuff tears.
was performed in all of the patients.
(1,3) Consider bursectomy, arthroscopic acromioplasty
, capsulotomy and/or debridement for recalcitrant cases.
More recently, a symptomatic patient with an implanted ICD underwent an uneventful ultrasound-guided interscalene block using 40 ml of 1.5% mepivacaine for arthroscopic acromioplasty
for chronic impingement syndrome of shoulder.
In addition, an acromioplasty
is performed in many cases where impingement signs are seen at surgery.
Treatment includes rest; cross-training; range of motion exercises; strengthening exercises; and, in more severe cases, debridement and acromioplasty
Partial resection of the coracoacromial ligament and acromioplasty
was done in nine patients, only in the presence of arthroscopic findings of subacromial impingement: two patients with a radiologically identified Bigliani type II acromion and seven patients with type III acromion.
Berg and Ciullo suggested that it might be a more common cause of failure of both acromioplasty
and distal clavicle resection.
The treating orthopedic surgeon has several options, including excision of the unfused segment, arthroscopic acromioplasty
, and several osteosynthesis techniques.
These two patients underwent acromioplasty
and repair of the rotator cuff tear as the primary treatment of the recurrent instability and will not be considered further in this report.