Arthroscopic repair of nontraumatic small to medium-sized full-thickness rotator cuff tears with and without acromioplasty: A prospective randomized controlled clinical study

Abstract

Rotator cuff tears (RCTs) are a common cause of shoulder dysfunction and are typically treated with arthroscopic repair. However, the routine use of acromioplasty for small to medium full-thickness tears remains controversial. This study evaluated the necessity of acromioplasty during arthroscopic repair. This prospective, randomized controlled trial rigorously investigated the efficacy of two distinct arthroscopic surgical approaches for degenerative RCTs. A cohort of 36 participants, ranging in age from 50 to 65 years, was enrolled based on specific inclusion criteria: small-to-medium-sized degenerative RCTs, defined as <3 cm in anteroposterior dimension, excellent overall health status, and the presence of either a type II or type III acromial morphology or acromial spurs. Participants were randomized into two equally sized groups and followed for a minimum of 12 months (range, 12–31 mo). Group A received arthroscopic rotator cuff repair complemented by bursectomy and an anteroinferior acromioplasty. Conversely, group B underwent arthroscopic rotator cuff repair with bursectomy alone, serving as the comparative intervention. Significant postoperative improvements in the American Shoulder and Elbow Surgeons score, the Western Ontario Rotator Cuff index, and shoulder range of motion were observed in both groups (all P <0.05). No statistically significant differences were identified between the acromioplasty and non-acromioplasty groups regarding postoperative functional outcomes, range of motion, complications, or magnetic resonance imaging–confirmed tendon integrity (all P >0.05). Concomitant acromioplasty during arthroscopic repair of small- to medium-sized degenerative RCTs offered no added functional or structural benefit.