Results after bursectomy and acromioplasty in treatment of subacromial impingement syndrome

Goal: Effectiveness of open subacromial decompression and acromioplasty (on anterior approach) for subacromial impingement syndrome. Materials and methods: The study group is composed of 62 patients, 32 women and 30 men, with a mean age of 56.2 years (extremes 39-71) who, between 2002 and 2006, underwent open acromioplasty using transdeltoidian anterior approach, accompanied by previous complete section of coracoacromial ligament and partial subacromial bursectomy for subacromial impingement syndrome; all patients had no lesions of the rotator cuff. A local anesthetic/steroid subacromial injection was administered to all patients with a clinical diagnosis of subacromial impingement syndrome. Among these, 51 patients had a positive injection test but the symptoms came back in less then one year and other 11 patients had a negative injection test but the diagnosis was sustained on MRI (they all together represent the “surgical” group). The results were evaluated according to Constant score at the onset of the disease, after the local anesthetic/ steroid subacromial injection and postoperative at 6 weeks, 3 months and 6 months after surgery. Results: The preoperative mean Constant score was 43 points (extremes 19-66), after subacromial injection 74 (extremes 49-89) and postoperative at 6 weeks 63 (extremes 31-81), at 3 months 76 (extremes 44-93), at 6 months 81 (extremes 48-98). Conclusions: The local anesthetic/steroid subacromial injection is an effective method of diagnosis and treatment of inflammatory arthropathy. Section of coracoacromial ligament, subacromial bursectomy and acromioplasty represent a good option in patients who don’t respond to conservative treatment. Results after bursectomy and acromioplasty in treatment of subacromial impingement syndrome Radu RADULESCU, Professor Assistant, Senior Orthopedic Surgeon, Head of Department, PhD; Adrian BADILA, Senior Orthopedic Surgeon; Octavian NUTIU, Junior Orthopedic Surgeon; Cristian NITA, Resident Orthopedic Surgery; Robert MANOLESCU, Resident Orthopedic Surgery Emergency University Hospital, Bucharest, Romania Address for correspondence: Radu Radulescu, MD, PhD, Emergency University Hospital, 169 Splaiul Independentei, District 5, Zip Code 050098, Bucharest, Romania email address: [email protected]