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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 4, 504-510.
doi: 10.1302/0301-620X.91B4.21442  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Bursectomy compared with acromioplasty in the management of subacromial impingement syndrome

A PROSPECTIVE RANDOMISED STUDY

H. E. Henkus, MD, Orthopaedic Surgeon1; P. B. de Witte, MS, Medical Student2; R. G. H. H. Nelissen, MD, PhD, Professor2; R. Brand, PhD, Senior Lecturer in Biostatistics3; and E. R. A. van Arkel, MD, PhD, Orthopaedic Surgeon4

1 Department of Orthopaedics, Haga ziekenhuis, lokatie RKZ, Sportlaan 600, 2566MJ, The Hague, The Netherlands.
2 Department of Orthopaedics
3 Department of Medical Statistics and Bioinformatics, Leiden University Medical Hospital, Albinsdreef 2, 2333, Za, Leiden, The Netherlands.
4 Department of Orthopaedics, MCH Hospital, lokatie, Westeiride, Lijnbaan 32, 2512, VA, The Hague, The Netherlands.

Correspondence should be sent to Dr H. E. Henkus; e-mail: HHenkus{at}planet.nl

In a prospective randomised study we compared the results of arthroscopic subacromial bursectomy alone with debridement of the subacromial bursa followed by acromioplasty. A total of 57 patients with a mean age of 47 years (31 to 60) suffering from primary subacromial impingement without a rupture of the rotator cuff who had failed previous conservative treatment were entered into the trial. The type of acromion was classified according to Bigliani. Patients were assessed at follow-up using the Constant score, the simple shoulder test and visual analogue scores for pain and functional impairment. One patient was lost to follow-up.

At a mean follow-up of 2.5 years (1 to 5) both bursectomy and acromioplasty gave good clinical results. No statistically significant differences were found between the two treatments. The type of acromion and severity of symptoms had a greater influence on the clinical outcome than the type of treatment. As a result, we believe that primary subacromial impingement syndrome is largely an intrinsic degenerative condition rather than an extrinsic mechanical disorder.




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[Abstract] [Full Text] [PDF]

eLetters:

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Bursectomy compared with acromioplasty in the management of subacromial impingement syndrome
Tom M Lawrence, et al.
J Bone Joint Surg Br Online, 6 May 2009 [Full text]
Author's reply
Hans-Erik Henkus
J Bone Joint Surg Br Online, 9 Jun 2009 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General