Arthroscopic subacromial decompression: acromioplasty versus bursectomy alone--does it really matter? A systematic review.

BACKGROUND: Subacromial impingement is a common disorder mat in some cases results in surgical management. Arthroscopic subacromial bursectomy alone or in combination with acromioplasty are treatment options when non-operative measures fail.

METHODS: A systematic review of all level-I and level-II studies regarding subacromial bursectomy and acromioplasty for impingement was performed. Medline publications were reviewed for appropriate studies.

RESULTS: A total of six studies that met inclusion criteria were identified. However, only one randomized study was identified that directly compared the treatments in question. Additionally, only one prospective study of subacromial bursectomy was identified. A comparison of similar outcome measures revealed bursectomy alone provided similar results to bursectomy with acromioplasty.

DISCUSSION: Limited high-level studies are available regarding arthroscopic treatment of subacromial impingement. Data available currently suggests that bursectomy alone provides similar outcomes to bursectomy with acromioplasty.