Patients With Impingement Syndrome With and Without Rotator Cuff Tears Do Well 20 Years After Arthroscopic Subacromial Decompression.
OBJECTIVE
To present the long-term outcome of arthroscopic subacromial decompression (ASD) for patients with impingement syndrome with or without rotator cuff tears as well as with or without calcific tendinitis in a follow-up of 20 years.


METHODS
We included 95 patients after a mean follow-up of 19.9 (19.5 to 20.5) years. All patients underwent ASD, including acromioplasty, resection of the coracoacromial ligament, and coplaning without cuff repair. The Constant score was used to assess the functioning of the shoulder. In addition, we defined a combined failure end point of a poor Constant score and revision surgery.


RESULTS
Revision surgery was performed in14.7% of the patients. The combined end point showed successful results in 78.8% of all cases. All patients with isolated impingement syndrome achieved successful results. Those with partial-thickness tears had successful outcomes in 90.9% of all cases, and patients with full-thickness tears had successful outcomes in 70.6% of all cases. The tendinitis calcarea group showed the poorest results, with a 65.2% success rate.


CONCLUSIONS
Our long-term results show that patients with impingement syndrome who received ASD, including acromioplasty, resection of the coracoacromial ligament, and coplaning do well 20 years after the index surgery. ASD without cuff repair even appears to be a safe, efficacious, and sustainable procedure for patients with partial rotator cuff tears.


METHODS
Level IV, therapeutic case series.
Clinic of Orthopedics, Traumatology and Sports Medicine, Klinikum Agnes Karll Laatzen, Klinikum Region Hannover, Laatzen, Germany. Electronic address: moritz.jaeger@posteo.de.
Moritz
M
Jaeger
Clinic of Orthopedics, Traumatology and Sports Medicine, Klinikum Agnes Karll Laatzen, Klinikum Region Hannover, Laatzen, Germany.
Thomas
T
Berndt
Clinic of Orthopedics, Traumatology and Sports Medicine, Klinikum Agnes Karll Laatzen, Klinikum Region Hannover, Laatzen, Germany.
Oliver
O
Rühmann
Clinic of Orthopedics, Traumatology and Sports Medicine, Klinikum Agnes Karll Laatzen, Klinikum Region Hannover, Laatzen, Germany.
Solveig
S
Lerch
D000174:Acromion / Q000601:surgery*; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D002061:Bursa, Synovial / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012782:Shoulder / Q000601:surgery; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery; D016896:Treatment Outcome