FIBROSIS IN THE SUBACROMIAL BURSA AND OUTCOME AFTER ACROMIOPLASTY

Background and aims: The subacromial bursa tends to undergo proliferat ive or degenerative changes in patients with impingement syndrome. The aim of the study was to quantify the degree of fibrosis in the subacr omial bursa in context with the outcome after acromioplasty. Material and Methods: Twenty-one patients with impingement syndrome underwent a cromioplasty, and in each case biopsies from the subacromial bursa wer e taken. Fibrosis in the subacromial bursa was assessed histologically with van Gieson staining technique, and a three-graded scale was used . Five normal shoulders from an autopsy series served as controls. Res ults and Conclusions: Ten patients had severe fibrosis, eight had mode rate fibrosis and one patient had no fibrosis at all. All normal contr ols had no fibrosis. The postoperative outcome seemed to be more favou rable in patients with severe fibrosis (7 out of 10) contrary to patie nts with moderate fibrosis of whom only three out of eight were graded as a success. The outcome of acromioplasty in patients with impingeme nt was clearly dependent on the degree of fibrosis in the subacromial bursa.