Randomized Prospective Trial of Arthroscopic Rotator Cuff with or without Acromioplasty: No Difference in Patient-Reported Outcomes at Long-Term Follow-up

The purpose of this study was to evaluate long-term patient-reported outcomes and revision surgery after arthroscopic rotator cuff repair with or without acromioplasty. Between 2007-2011, prospectively enrolled patients undergoing arthroscopic repair for full-thickness rotator cuff tears, with any acromial morphology, were randomized into either acromioplasty or non-acromioplasty groups. Patients with revision surgery, subscapularis involvement, advanced neurologic conditions, or death were excluded. Baseline and long-term follow-up questionnaires, including the American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), University of California-Los Angeles (UCLA), Visual Analog Scale (VAS) for pain, and Constant scores were obtained. Rates of symptomatic retear, revision rotator cuff surgery, or secondary reoperation were recorded. Averages with standard deviation (SD) were calculated, and t-tests were utilized to compare outcomes of interest between cohorts. In total, 69 of 90 patients (76.7%) were available at 92.4 months (±10.5). There were 23/32 patients in the acromioplasty cohort and 24/37 patients in the non-acromioplasty cohort. Mean age for the non-acromioplasty cohort was 56.9 (± 7.6) while acromioplasty was 59.6 (±6.8). Comparison of baseline demographics and intraoperative information revealed no significant differences, including age, gender, workers compensation, acute mechanism of injury, tear size, degree of retraction, and surgical technique (e.g. single- vs. double-row). At final follow-up, there were no statistically significant differences according to ASES (p=0.33), VAS pain (p=0.79), Constant (p=0.17), SST (p=0.05), UCLA (p=0.19), and SF-12 (p=0.79) in patients with and without acromioplasty. Two patients with acromioplasty (5.6%) and three patients without acromioplasty (9.1%) sustained atraumatic recurrent rotator cuff tear with secondary repair (p=0.99), and there was no significant difference in retear rates or patient-reported outcome measures by acromial morphology. This randomized trial, with mean 7.5-year follow-up, found no difference in validated patient-reported outcomes, retear rate, or revision surgery rate between subjects undergoing rotator cuff repair with or without acromioplasty.