P. Hyvonen et al., Open acromioptasty does not prevent the progression of an impingement syndrome to a tear - Nine-year follow-up of 96 cases, J BONE-BR V, 80B(5), 1998, pp. 813-816
Citations number
19
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
We performed open acromioplasty for intractable impingement syndrome on 96
shoulders (93 patients) with an intact rotator cuff. All the shoulders were
examined by ultrasound after a mean interval of nine years. Those showing
pathological findings, a poor or fair subjective result, or deterioration o
f the primacy excellent outcome had MRI and/or arthrography.
The mean Constant score for the affected shoulders was 70 points and that f
or 48 non-involved, symptom-free shoulders, 84 points. The subjective outco
me was excellent in 45, good in 24, fair in 18 and poor in 9 shoulders, Com
plete tears were found in 12 shoulders and partial tears in seven, A total
of 14 shoulders was symptom-free after acromioplasty, but after an average
of five years became painful again and showed deterioration. Of these, six
had complete tears and four partial tears of the cuff. The tear rate was 4%
in shoulders initially judged to be excellent, 25% in good, 33% in fair an
d 55% in poor shoulders. The tear rate was 71% in shoulders which subsequen
tly deteriorated, The incidence was higher in men (25%) than in women (11%)
.
We conclude that a tear of the rotator cuff may appear after acromioplasty,
although there was no evidence of a tear at the time of operation, This is
usually the reason for deterioration in a shoulder with an initially good
operative outcome.