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Edward G. Mcfarland - One of the best experts on this subject based on the ideXlab platform.
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Is Acromioplasty necessary in the setting of full-thickness rotator cuff tears? A systematic review
Journal of Orthopaedics and Traumatology, 2015Co-Authors: Filippo Familiari, Alan Gonzalez-zapata, Bruno Iannò, Olimpio Galasso, Giorgio Gasparini, Edward G. McfarlandAbstract:Background The benefits of Acromioplasty in treating rotator cuff disease have been debated. We systematically reviewed the literature regarding whether Acromioplasty with concomitant coracoacromial(CA) release is necessary for the successful treatment of full-thickness rotator cuff tears. Materials and methods We identified randomized controlled trials that reported on patients who underwent rotator cuff repair with or without Acromioplasty and used descriptive statistics to summarize the findings. Results Four studies fulfilled the inclusion criteria. They reported on 354 patients (mean age, 59 years; range 3–81 years) with a mean follow-up of 22 months (range 12–24 months). There were two level-I and two level-II studies. Two studies compared rotator cuff repair with versus without Acromioplasty, and two studies compared rotator cuff repair with versus without subacromial decompression (Acromioplasty, CA ligament resection, and bursectomy). The procedures were performed arthroscopically, and the CA ligament was released in all four studies. There were no statistically significant differences in clinical outcomes between patients treated with Acromioplasty compared with those treated without Acromioplasty. Conclusions This systematic review of the literature does not support the routine use of partial Acromioplasty or CA ligament release in the surgical treatment of rotator cuff disease. In some instances, partial Acromioplasty and release of the CA ligament can result in anterior escape and worsening symptoms. Further research is needed to determine the optimum method for the operative treatment of full-thickness rotator cuff tears. Level of evidence Level I, systematic review of level I and II studies.
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is Acromioplasty necessary in the setting of full thickness rotator cuff tears a systematic review
Journal of Orthopaedics and Traumatology, 2015Co-Authors: Filippo Familiari, Bruno Iannò, Olimpio Galasso, Giorgio Gasparini, Alan Gonzalezzapata, Edward G. McfarlandAbstract:Background The benefits of Acromioplasty in treating rotator cuff disease have been debated. We systematically reviewed the literature regarding whether Acromioplasty with concomitant coracoacromial(CA) release is necessary for the successful treatment of full-thickness rotator cuff tears.
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limited lateral Acromioplasty for rotator cuff surgery
Orthopedics, 2005Co-Authors: Edward G. Mcfarland, Hyung Bin Park, Atsushi Yokota, Harpreet S GillAbstract:This article describes a modified technique for Acromioplasty performed during rotator cuff repair.
Filippo Familiari - One of the best experts on this subject based on the ideXlab platform.
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Is Acromioplasty necessary in the setting of full-thickness rotator cuff tears? A systematic review
Journal of Orthopaedics and Traumatology, 2015Co-Authors: Filippo Familiari, Alan Gonzalez-zapata, Bruno Iannò, Olimpio Galasso, Giorgio Gasparini, Edward G. McfarlandAbstract:Background The benefits of Acromioplasty in treating rotator cuff disease have been debated. We systematically reviewed the literature regarding whether Acromioplasty with concomitant coracoacromial(CA) release is necessary for the successful treatment of full-thickness rotator cuff tears. Materials and methods We identified randomized controlled trials that reported on patients who underwent rotator cuff repair with or without Acromioplasty and used descriptive statistics to summarize the findings. Results Four studies fulfilled the inclusion criteria. They reported on 354 patients (mean age, 59 years; range 3–81 years) with a mean follow-up of 22 months (range 12–24 months). There were two level-I and two level-II studies. Two studies compared rotator cuff repair with versus without Acromioplasty, and two studies compared rotator cuff repair with versus without subacromial decompression (Acromioplasty, CA ligament resection, and bursectomy). The procedures were performed arthroscopically, and the CA ligament was released in all four studies. There were no statistically significant differences in clinical outcomes between patients treated with Acromioplasty compared with those treated without Acromioplasty. Conclusions This systematic review of the literature does not support the routine use of partial Acromioplasty or CA ligament release in the surgical treatment of rotator cuff disease. In some instances, partial Acromioplasty and release of the CA ligament can result in anterior escape and worsening symptoms. Further research is needed to determine the optimum method for the operative treatment of full-thickness rotator cuff tears. Level of evidence Level I, systematic review of level I and II studies.
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is Acromioplasty necessary in the setting of full thickness rotator cuff tears a systematic review
Journal of Orthopaedics and Traumatology, 2015Co-Authors: Filippo Familiari, Bruno Iannò, Olimpio Galasso, Giorgio Gasparini, Alan Gonzalezzapata, Edward G. McfarlandAbstract:Background The benefits of Acromioplasty in treating rotator cuff disease have been debated. We systematically reviewed the literature regarding whether Acromioplasty with concomitant coracoacromial(CA) release is necessary for the successful treatment of full-thickness rotator cuff tears.
Manuel Marin - One of the best experts on this subject based on the ideXlab platform.
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open anterior Acromioplasty with preservation of the coracoacromial ligament a modified surgical technique
Journal of Shoulder and Elbow Surgery, 2003Co-Authors: Carlos Torrens, Joan Miquel Lopez, Enrique Verdier, Manuel MarinAbstract:Abstract The importance of the preservation of the subacromial arch has been stressed recently, especially in irreparable lesions of the rotator cuff to prevent anterosuperior migration of the humeral head. The purpose of this article is to describe the surgical technique of a modified open anterior Acromioplasty performed through an intra-acromial osteotomy that increases the subacromial space and preserves the insertion of the coracoacromial ligament on the undersurface of the acromion. To compare this new technique with classical Acromioplasty, a prospective but nonrandomized study was performed including 20 patients undergoing open anterior Acromioplasty and 22 patients undergoing a modified open anterior Acromioplasty. At a mean follow-up of 18 months, no differences related to shoulder function as evaluated by the Constant score were found between these two groups. This modified Acromioplasty increases the subacromial space, preserving the anatomy of the subacromial arch, and provides functional results as good as those obtained with classical open Acromioplasty. (J Shoulder Elbow Surg 2003;12:9-14)
Brian R Wolf - One of the best experts on this subject based on the ideXlab platform.
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arthroscopic subacromial decompression Acromioplasty versus bursectomy alone does it really matter a systematic review
The Iowa orthopaedic journal, 2011Co-Authors: Jonathan A Donigan, Brian R WolfAbstract:Background Subacromial impingement is a common disorder mat in some cases results in surgical management. Arthroscopic subacromial bursectomy alone or in combination with Acromioplasty are treatment options when non-operative measures fail.
Peter Lapner - One of the best experts on this subject based on the ideXlab platform.
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arthroscopic rotator cuff repair with and without Acromioplasty in the treatment of full thickness rotator cuff tears a multicenter randomized controlled trial
Journal of Bone and Joint Surgery American Volume, 2011Co-Authors: P.b. Macdonald, J. Leiter, R. Mascarenhas, S. Mcrae, Peter LapnerAbstract:Background: The primary objective of this prospective randomized controlled trial was to compare functional and quality-of-life indices and rates of revision surgery in arthroscopic rotator cuff repair with and without Acromioplasty. Methods: Eighty-six patients consented and were randomly assigned intraoperatively to one of two study groups, and sixty-eight of them completed the study. The primary outcome was the Western Ontario Rotator Cuff (WORC) index. Secondary outcome measures included the American Shoulder and Elbow Surgeons (ASES) shoulder assessment form and a count of revisions required in each group. Outcome measures were completed preoperatively and at three, six, twelve, eighteen, and twenty-four months after surgery. Results: WORC and ASES scores improved significantly in each group over time (p < 0.001). There were no differences in WORC or ASES scores between the groups that had arthroscopic cuff repair with or without Acromioplasty at any time point. There were no differences in scores on the basis of acromion type, nor were any interaction effects identified between group and acromion type. Four participants (9%) in the group that had arthroscopic cuff repair alone, one with a Type-2 and three with a Type-3 acromion, required additional surgery by the twenty-four-month time point. The number of patients who required additional surgery was greater (p = 0.05) in the group that had arthroscopic cuff repair alone than in the group that had arthroscopic cuff repair and Acromioplasty. Conclusions: Our findings are consistent with previous research reports in which there was no difference in functional and quality-of-life indices for patients who had rotator cuff repair with or without Acromioplasty. The higher reoperation rate was found in the group without Acromioplasty. Further study that includes follow-up imaging and patient-reported outcomes over a greater follow-up period is needed. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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ARTHROSCOPIC ROTATOR CUFF REPAIR WITH AND WITHOUT ARTHROSCOPIC Acromioplasty IN THE TREATMENT OF FULL THICKNESS ROTATOR CUFF TEARS
2009Co-Authors: P.b. Macdonald, Peter Lapner, J. Leiter, R. Mascarenhas, S. McraeAbstract:The purpose of this prospective randomised clinical trial is to examine the effect of Acromioplasty on the outcome of arthroscopic rotator cuff repair. Patients included individuals that were referred for assessment after six months of failed conservative management. Following informed consent patients were randomly assigned to receive arthroscopic rotator cuff repair with or without Acromioplasty. The surgeon was not blinded to the type of procedure; however, the researcher who performed the follow-up evaluations and the patient was blinded to the surgical protocol. Subacromial decompression (Acromioplasty) was performed with release of the coracoacromial ligament off the anterior undersurface of the acromion. The procedure for arthroscopic cuff repair without Acromioplasty followed the protocol of arthroscopic cuff repair with Acromioplasty, without division of the coracoacromial ligament or resection of the acromion. Both groups experienced the same post-operative rehabilitation protocol. Wound healing and active and passive range of motion were assessed and recorded at six to eight weeks post-operatively. Subsequent post-operative visits occurred at three, six, twelve, eighteen and twenty-four months and included documentation of patient range of motion, patient derived WORC scores (1) and complete ASES scores. Preliminary results suggest, based on a one-tailed t-test, patients that receive a rotator cuff repair with Acromioplasty demonstrate a statistically significant improvement ( Arthroscopic rotator cuff repair with arthroscopic Acromioplasty in the treatment of full thickness rotator cuff tears is recommended for patients with a Type III acromion.
