Results of arthroscopic treatment of rotator cuff tear with the resection of symptomatic acromioclavicular joint with degenerative changes.
BACKGROUND
Rotator cuff (RC) tear is one of the most common disorders affecting the shoulder. Acromioclavicular (AC) joint arthritis is an equally common pathology of the shoulder. The coexistence of both disorders is common, although RC tear is more frequently the cause of shoulder pain than AC joint arthritis. The purpose of this study was to compare the results of arthroscopic treatment of RC tear and simultaneous resection of symptomatic AC joint with arthritis.


METHODS
We retrospectively evaluated 40 patients who underwent arthroscopic RC repair between January 2008 and December 2009. Patients were divided into two groups. The first group consisted of 20 patients with symptomatic arthritis of AC joint, specifically painful joint palpation test and painful cross-body adduction test. The control group included 20 patients with asymptomatic degenerative changes of AC joint. The first group of patients underwent RC resection and AC joint repair; the second group had an isolated RC repair. Follow-up period lasted from 44 to 68 months, an average of 54.4 months.


RESULTS
Analysis using chi-squared test for independence has shown no statistically significant difference in terms of subjects' gender or age in both groups. No significant difference in terms of pain intensity (VAS) was observed before and after surgery in either group. Significant reduction in pain intensity after surgery was observed in both groups, the AC joint resection group (p<0.001) and the without joint resection group (p<0.001). An increase in Constant's scale score was recorded in both groups after the surgery. Analysis has shown that patients who had undergone AC joint resection, had lower scores on a Constant's scale (p<0.022) before the surgery than those who were not resected. There were no statistically significant differences between the two groups after the surgery.


CONCLUSIONS
Supplementary resection of a painful AC joint with arthritis during RC tear repair provides good, long-term outcomes. In contrast to patients with asymptomatic AC joint arthritis, the coexistence of a torn RC and symptomatic AC joint with arthritis, can worsen shoulder function in the preoperative period.
1 Department of Orthopedics, St. Luke's Clinic, Bielsko-Biała, Poland 2 Department of Traumatology and Orthopedics, St. Maximilian Hospital in Oświęcim, Oświęcim, Poland.
Adrian
A
Błasiak
Michał
M
Mojżesz
Roman
R
Brzóska
Wojciech
W
Solecki
Aneta
A
Binkowska
D000173:Acromioclavicular Joint / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000145:classification / Q000209:etiology; D001168:Arthritis / Q000601:surgery; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D022125:Lacerations / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D016896:Treatment Outcome