Evaluation of Short-Term Outcomes of Arthroscopic Bursectomy Without Acromioplasty for Shoulder Impingement Syndrome With Type I and Type II Acromia

Purpose: To evaluate the efficacy of arthroscopic bursectomy in impingement syndrome with type I and type II acromia. Materials and Methods: Patients of shoulder impingement syndrome that did not improve on 6 weeks of conservative treatment were included. Patients with hooked acromion and full thickness rotator cuff tear were excluded based on radiological and ultrasonographic assessment. Arthroscopic bursectomy was performed in the selected patients. Constant–Murley score was used for evaluation preoperatively and at fixed intervals till 12 weeks postoperatively. Wilcoxon signed ranks test was performed for statistical analysis of nonparametric data. Results: The average age of patients was 40.5 years. The majority of the patients were males (70%) with involvement of dominant side, and seven had involvement of the nondominant side. Type I acromion and type II acromion were seen in 10 patients each. Ultrasound was able to detect all patients who had rotator cuff tear (20%), as confirmed during diagnostic arthroscopy. Type II acromion was found in three out of these four patients. All parameters of the Constant–Murley score worsened at 2 weeks postoperatively but showed statistically significant improvement during subsequent follow-up. Eight patients (40%) were rated as having excellent result, four patients (20%) as having good result, four (20%) as having fair result. These 16 patients (80%) were satisfied with the overall result. Four patients had a partial thickness rotator cuff tear. Out of these, three had poor outcome and one had fair outcome. Conclusions: Satisfactory outcomes were achieved in 80% of our patients. However, four patients in our study did not show encouraging results, thereby stressing the role of extrinsic factors also in the pathogenesis of impingement syndrome. Hence we recommend arthroscopic busrectomy for patients with shoulder impingement syndrome after exhausting conservative treatment, excluding a hooked acromion and rotator cuff tear. Level of Evidence: Level II − prospective interventional study