ARTHROSCOPIC ACROMIO – PLASTY IN THE TREATMENT OF SUB – ACROMIAL IMPINGEMENT

Purpose: To present our experience in the treatment of sub-acromial impingement by the method of arthroscopic acromioplasty. Material – Method: This study includes 41 patients (17 males and 24 females) with average age 53.07 years (range 22 – 69). All patients were suffering from intense pain in the shoulder joint and presented movement limitation. The patients were evaluated clinically and with plain Xrays and MRI of the region. Prior to the intervention all the patients had followed a variety of adequate conservative treatment including immobilization, anti-inflammatory therapy, physical therapy, local infiltration with corticoids and xylocain. The results proved unsatisfactory. The surgical technique consisted of triple portal arthhroscopic intervention (anterior, posterior, lateral) and the use of a shaver for the completion of the acromio – plasty. The surgical time was 40 minutes (30 – 55) The post – operative protocol, which included passive and active physiotherapy, was identical for all patients. Results: The required average hospitalization was 36 hours (14 – 48). The average time needed for satisfactory rehabilitation amounted to 27 days (20 – 45). We followed closely our patients for an average of 11 months. (4 – 16). The painful symptoms disappeared thoroughly in 92.7% of our cases (38). Moderate pain persisted in 7.3% (3). Shoulder movements were fully restored in 95.1% (39). We observed no peri-operative or post – operative complications. Conclusions: The arthroscopic airomioplasty is the surgical treatment of choice in the cases of sub-aromial impingement. The method presents no great technical difficulties. The operative time is considered short, and the results in their great majority are excellent. The hospitalization needed is minimal, the rehabilitation is rapid, and the economic cost is not significant. We firmly believe that the arthroscopic acromio – plasty is the treatment of choice in the case of failed conservative treatment.