This is a retrospective case series testing whether adding arthroscopic lateral acromioplasty to rotator cuff repair reliably lowers the critical shoulder angle. It asks two questions: does the procedure correct the CSA into the favorable range, and does resecting the lateral acromion damage the deltoid origin or muscle? Forty-nine patients with degenerative full-thickness tears and a CSA of 34° or greater were followed for a mean of 30 months.
The critical shoulder angle is a fixed anatomic predictor of degenerative cuff disease: above 34° drives cuff tears, at or below 30° drives osteoarthritis. This paper tests whether you can actually change that angle surgically and get away with it.
The practical answer is yes on safety. Resecting roughly 6 mm of lateral acromion did not detach or atrophy the deltoid origin on MRI or exam, which was the main fear with this technique.
The useful clinical lesson is on dose. Shoulders corrected to 33° or less had stronger abduction and healed more reliably, while residually large angles (near 36°) retore more often. If you do this, correct fully rather than partially.
Weight the evidence carefully. This is a Level IV case series with no control group and no comparison to standard repair. It proves the procedure is safe and biomechanically rational, not that it beats rotator cuff repair alone.
This is a retrospective case series testing whether adding arthroscopic lateral acromioplasty to rotator cuff repair reliably lowers the critical shoulder angle. It asks two questions: does the procedure correct the CSA into the favorable range, and does resecting the lateral acromion damage the deltoid origin or muscle? Forty-nine patients with degenerative full-thickness tears and a CSA of 34° or greater were followed for a mean of 30 months.
The critical shoulder angle is a fixed anatomic predictor of degenerative cuff disease: above 34° drives cuff tears, at or below 30° drives osteoarthritis. This paper tests whether you can actually change that angle surgically and get away with it.
The practical answer is yes on safety. Resecting roughly 6 mm of lateral acromion did not detach or atrophy the deltoid origin on MRI or exam, which was the main fear with this technique.
The useful clinical lesson is on dose. Shoulders corrected to 33° or less had stronger abduction and healed more reliably, while residually large angles (near 36°) retore more often. If you do this, correct fully rather than partially.
Weight the evidence carefully. This is a Level IV case series with no control group and no comparison to standard repair. It proves the procedure is safe and biomechanically rational, not that it beats rotator cuff repair alone.