Guided versus freehand acromioplasty during rotator cuff repair. A randomized prospective study.

Details

Ressource 1Request a copy Sous embargo indéterminé.
State: Public
Version: Author's accepted manuscript
License: Not specified
Serval ID
serval:BIB_020226FB1024
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Guided versus freehand acromioplasty during rotator cuff repair. A randomized prospective study.
Journal
Orthopaedics & traumatology, surgery & research
Author(s)
Lädermann A., Chagué S., Preissmann D., Kolo F.C., Rime O., Kevelham B., Bothorel H., Charbonnier C.
ISSN
1877-0568 (Electronic)
ISSN-L
1877-0568
Publication state
Published
Issued date
06/2020
Peer-reviewed
Oui
Volume
106
Number
4
Pages
651-659
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
There is no consensus on how to perform acromioplasty, particularly regarding the level and extent of bone resection, which depend on scapular and humeral morphologies.
We aimed to determine whether computer-assisted acromioplasty planning helps surgeons remove impinging bone, reduce unnecessary resections, and improve short-term outcomes of rotator cuff tears (RCR).
We randomized 64 patients undergoing RCR of full-thickness supraspinatus tears into two groups: 'guided acromioplasty' (GA) and 'freehand acromioplasty' (FA). The pre- and post-operative scapula models were reconstructed using computed-tomography scans to quantify impinging bone removal, unnecessary bone resections, and identify zones of acromial bone removal. All patients were evaluated preoperatively and at 6 months to assess their range of motion (ROM), functional scores and tendon integrity using ultrasound.
The two groups did not differ in demographics, clinical or morphologic characteristics. Compared to FA, GA tended to lower impinging bone removal (55±26% vs. 43±27%, p=0.087) and to increase unnecessary resection of the total bone removed (49±22% vs. 57±27%, p=0.248). GA resulted in significant anterior under-resection, while FA resulted in significant medial over-resection. Clinical outcomes and ROM improved significantly for all patients, except for internal rotation in the GA group. There were no other significant differences between the two groups, neither in terms of post-operative scores nor in terms of clinical net improvements, nor tendon repair integrity.
This computer-assisted planning for acromioplasty during RCR proved no benefits in terms of bone removal, tendon healing, or clinical outcomes. Nonetheless such planning tools could help less experienced surgeons improve the efficacy of acromioplasty.
I, Randomized controlled trial (Therapeutic study).
Keywords
Surgery, Orthopedics and Sports Medicine, 3D surgical planning, Acromioplasty, Guided versus freehand, Rotator cuff repair, Shoulder, Subacromial impingement
Pubmed
Web of science
Create date
25/05/2020 10:30
Last modification date
11/07/2020 6:18
Usage data