Arthroscopic versus open acromioplasty: a meta-analysis.
BACKGROUND
To address persisting controversy in the literature concerning the efficacy of arthroscopic compared to open acromioplasty, a meta-analysis was performed to evaluate the treatment effect after both approaches.


OBJECTIVE
The final clinical outcomes will be the same after both open and arthroscopic acromioplasty. However, the arthroscopic technique results in faster recovery and less postoperative morbidity as reflected by faster return to work and decreased hospital stays.


METHODS
Meta-analysis; Level of evidence, 3.


METHODS
We performed our search of published English language literature using PubMed. We also searched the proceedings from 4 major orthopaedic meetings convened from 2000 to 2007. Furthermore, the reference sections of all relevant articles were reviewed for pertinent studies and presentations. Nine studies met the inclusion criteria that directly compared arthroscopic versus open acromioplasty with minimum follow-up of 1 year. The analysis focused on 1-year clinical outcome and included comparison of the objective 100-point score, hospital stay, time until return to work, operative time, and complications.


RESULTS
No significant differences were found in clinical outcomes or complications for the 2 groups. However, open acromioplasty was associated with longer hospital stays (2.3 days, P = .05) and a greater length in time until return to work (65.1 days) compared with the arthroscopic technique (48.6 days) (P < .05).


CONCLUSIONS
Arthroscopic and open acromioplasty have equivalent ultimate clinical outcomes, operative times, and low complication rates. However, arthroscopic acromioplasty results in faster return to work and fewer hospital inpatient days compared with the open technique.
Davis
A David
AD
Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA, USA.
Kakar
Sanjeev
S
Moros
Chris
C
Kaye
Elizabeth Krall
EK
Schepsis
Anthony A
AA
Voloshin
Ilya
I
D000174:Acromion / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D002986:Clinical Trials as Topic; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007902:Length of Stay; D010149:Postoperative Pain / Q000601:surgery; D016059:Range of Motion, Articular; D020127:Recovery of Function; D017006:Rotator Cuff / Q000601:surgery; D019534:Shoulder Impingement Syndrome / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery; D016896:Treatment Outcome