Subacromial Smoothing.

Last updated Wednesday, January 26, 2005

Failed acromioplasty

Complaints

Postacromioplasty complaints often include:

• no improvement,
• increased pain,
• loss of anterior deltoid strength,
• increased stiffness, and
• anterior-superior instability.

Causes of failure

These failed open or arthroscopic acromioplasties were usually performed for a preoperative diagnosis listed as "impingement syndrome." However, a careful history often suggests other diagnoses, such as a partially frozen shoulder, cuff strain, partial cuff tears, and nonspecific shoulder pain. Thus these failures seem to be due to:

1. performing an acromioplasty for nonspecific shoulder symptoms;
2. performing an acromioplasty in the presence of shoulder stiffness;
3. failing to institute immediate postoperative motion, allowing for subacromial scarring;
4. failing to manage rotator cuff pathology;
5. failing to assure a strong deltoid reattachment to the acromion; or
6. performing a technically poor acromioplasty in which either an excessive amount of acromion was removed, the acromion was transected, or an irregular undersurface of the acromion was left as a new and persisting cause of roughness in the nonarticular humeroscapular motion interface.

Disclaimer

This resource has been provided by the University of Washington Department of Orthopaedics and Sports Medicine as general information only. This information may not apply to a specific patient. Additional information may be found at http://www.orthop.washington.edu or by contacting the UW Department of Orthopaedics and Sports Medicine.

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