Chow Andrew K, Sribhashyam Sashrik, Velichala Suhas R, Smith Matthew, Cassidy Benjamin, Satalich James R, Cyrus John, Goodloe Jonathan
Virginia Commonwealth University.
Orthopaedic Surgery Virginia Commonwealth University Medical Center.
Orthop Rev (Pavia). 2025 Jun 5;17:138666. doi: 10.52965/001c.138666. eCollection 2025.
In patients with shoulder impingement syndrome unresponsive to nonoperative treatment, surgical management is often recommended. This historical review goes into depth on how through research, evidence, and modern technologies, the surgical technique can evolve over time.
This study aims to provide a review of the literature comparing outcomes of arthroscopic versus open acromioplasty and discuss how the evidence influences surgical techniques and surgeons' modern day preferences.
Following PRISMA reporting standards, Medline, Embase (OVID), Web of Science, Pubmed, and Cochrane were searched through October 2024 for studies comparing arthroscopic and open acromioplasty for shoulder impingement syndromes. Outcomes of interest included operating time, hospital stay, range of motion, muscle strength, patient satisfaction, and UCLA shoulder score.
Seventeen studies evaluated 1,293 patients (763 males and 530 females) with a mean age of 45.4 years old, who underwent either arthroscopic or open acromioplasty. Both groups showed similar improvements in range of motion, muscle strength, and patient satisfaction. Patients who underwent arthroscopic acromioplasty had quicker recovery and shorter hospital stays, with reduced operative times when performed by experienced surgeons. Outcome scores (UCLA and Constant scores) were generally higher in the arthroscopic group; however, the results were not always statistically significant.
Over time, the standard of care has shifted to arthroscopic acromioplasty as it offers better recovery times and improved cosmetic results, making it the favored approach for shoulder impingement syndromes in patients and surgeons alike. Through continued research and surgical innovation surgical techniques can evolve and ultimately improve patient care.
对于非手术治疗无反应的肩部撞击综合征患者，通常建议进行手术治疗。本历史回顾深入探讨了通过研究、证据和现代技术，手术技术如何随时间演变。
本研究旨在综述比较关节镜下与开放性肩峰成形术结果的文献，并讨论证据如何影响手术技术和外科医生的现代偏好。
按照PRISMA报告标准，检索了截至2024年10月的Medline、Embase（OVID）、Web of Science、Pubmed和Cochrane数据库，以查找比较关节镜下和开放性肩峰成形术治疗肩部撞击综合征的研究。感兴趣的结果包括手术时间、住院时间、活动范围、肌肉力量、患者满意度和加州大学洛杉矶分校（UCLA）肩部评分。
17项研究评估了1293例患者（763例男性和530例女性），平均年龄45.4岁，这些患者接受了关节镜下或开放性肩峰成形术。两组在活动范围、肌肉力量和患者满意度方面均有相似改善。接受关节镜下肩峰成形术的患者恢复更快，住院时间更短，由经验丰富的外科医生进行手术时手术时间也会缩短。关节镜组的结果评分（UCLA和Constant评分）通常更高；然而，结果并不总是具有统计学意义。
随着时间的推移，护理标准已转向关节镜下肩峰成形术，因为它具有更好的恢复时间和改善的美容效果，使其成为患者和外科医生治疗肩部撞击综合征的首选方法。通过持续的研究和手术创新，手术技术可以不断发展，最终改善患者护理。
