University of Brescia (M.F.S.).
Arthroscopy. 2021 Oct;37(10):3079-3080. doi: 10.1016/j.arthro.2021.07.012.
Acromioplasty is a well-known, simple, and reproducible surgical technique that is used in isolation or in combination with other arthroscopic procedures. The clinical value of acromioplasty combined with arthroscopic rotator cuff repair has been largely investigated. Main theoretical benefits lie in the opportunity to improve the visualization, decrease abrasive wear with prominent acromial morphology, and release natural growth factors. On the other hand, acromioplasty and release of the coracoacromial ligament may weaken the insertion of the deltoid muscle, induce scar formation in the subacromial space, theoretically limiting shoulder mobility, and increase risk of anterior-superior humeral escape, especially in patients with large to massive rotator cuff tears. Clinical studies report conflicting results. My results show no differences in clinical outcomes in rotator cuff repairs with or without subacromial decompression, regardless of the acromial morphology. At the same time, I do believe that confirmatory studies are always necessary, especially if the aim is to disprove the usefulness of a common practice.
肩峰成形术是一种众所周知的、简单且可重复的手术技术，可单独使用或与其他关节镜手术联合使用。肩峰成形术联合关节镜下肩袖修复的临床价值已得到广泛研究。其主要理论优势在于有机会改善可视化效果、减少因肩峰形态突出而导致的磨损、释放天然生长因子。另一方面，肩峰成形术和喙肩韧带松解可能会削弱三角肌的附着，导致肩峰下空间形成瘢痕，理论上会限制肩部活动度，并增加前上肱骨逃逸的风险，尤其是在大到巨大肩袖撕裂的患者中。临床研究报告的结果相互矛盾。我的研究结果显示，无论肩峰形态如何，在肩袖修复中进行或不进行肩峰下减压，其临床结果均无差异。同时，我确实认为，确认性研究总是必要的，特别是如果目的是证明一种常见做法的无用性。
