Arthroscopic Decompression in the Management of Subacromial Impingement Syndrome

Background: Open acromioplasty has classically been described as a method of treatment for subacromial shoulder impingement syndrome. However, the arthroscopic method of management has also recently gained wide popularity. Objective: The aim of this work was to present clinical outcome of arthroscopic decompression in the management of subacromial shoulder impingement syndrome. Study Design: A case series. Patients and Methods: The study involved 30 patients with stage II-III impingement; 18 females (60%) and 12 males (40%). Arthroscopic decompression was done from the bursal side (subacromial decompression). Among other exclusion criteria in this series; there were no cases with concomitant rotator cuff ruptures requiring repair. Outcome Measures: The primary outcome measure was success of the procedure as judged by postoperative University of California at Los Angeles (ULCA) score on the last followup visit and Neer Criteria for "satisfaction". The secondary outcome was complications of the procedure. Results: Average age at time of operation was 43.3 years. The mean follow-up was 25 months (range, 9-45). Outcome was satisfactory in 90%; 53.3% excellent and 36.7% good. Three patients had unsatisfactory results; 2 fair and one poor. No postoperative complications were found. Conclusion: Results of arthroscopic subacromial decompression-though somewhat technically demanding-are gratifying when performed properly in selected patients. Hospitalization is brief with rapid return to daily activities and little risk of deltoid muscle complications.