Revision rates after arthroscopic operations in the subacromial space.

Problem: In the present study, we evaluated the failure and revisions rates after arthroscopic subacromial decompression(SAD). Method: We examined 83 patients who were treated with arthroscopic subacromial decompression for p rimary shoulder impingement (stage II and stage III according to Neer) at a n average follow-up time of 30 months. Hereby, special attention was paid t o the revision operations resulting from our treatment. Results: In patient s with impingement stage II, the mean follow-up Constant-score was 84.7 (SD +/-16.7) while in patients with impingement stage III it was 78.0 (SD +/-2 1.8). In ten patients (12%) revision operation had to be performed, nine of them with initial stage II impingement and one with initial stage III impi ngement. Reasons for revisions were persisting or increasing pain as well a s functional dissatisfaction. At the follow up examination. six of these re vised patients (60%) were satisfied with the result. The mean follow up Con stant-score in the revised patients was 77.3 (SD +/- 17.4). In 60 % of the revised patients the necessity for the revision operation was directly rela ted to the technical problems at the primary operation, in 40 % we found re asons not related to the primary SAD. Conclusions: Technical falls are the most common cause for the need of revision operations after SAD. This demon strates how demanding this kind of operation procedure is. In case of revis on operations individual strategies should be developed in which the decisi on whether to perform arthroscopic or open revision procedures is of specia l importance.