title: Arthroscopic versus open acromioplasty: a meta-analysis.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA, USA.
authors.forename: A David
authors.initials: AD
authors.lastname: Davis
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kakar
authors.forename: Chris
authors.initials: C
authors.lastname: Moros
authors.forename: Elizabeth Krall
authors.initials: EK
authors.lastname: Kaye
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Schepsis
authors.forename: Ilya
authors.initials: I
authors.lastname: Voloshin
mesh_terms: 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