Arthroscopic repair of nontraumatic small to medium-sized full-thickness rotator cuff tears with and without acromioplasty: A prospective randomized controlled clinical study

Background: Rotator cuff tears (RCTs) are a common cause of shoulder dysfunction and are typically treated with arthroscopic repair. However, the routine use of acromioplasty for small to medium full-thickness tears remains controversial. This study evaluated the necessity of acromioplasty during arthroscopic repair. Materials and Methods: This prospective, randomized controlled trial rigorously investigated the efficacy of two distinct arthroscopic surgical approaches for degenerative RCTs. A cohort of 36 participants, ranging in age from 50 to 65 years, was enrolled based on specific inclusion criteria: small-to-medium-sized degenerative RCTs, defined as <3 cm in anteroposterior dimension, excellent overall health status, and the presence of either a type II or type III acromial morphology or acromial spurs. Participants were randomized into two equally sized groups and followed for a minimum of 12 months (range, 12–31 mo). Group A received arthroscopic rotator cuff repair complemented by bursectomy and an anteroinferior acromioplasty. Conversely, group B underwent arthroscopic rotator cuff repair with bursectomy alone, serving as the comparative intervention. Results: Significant postoperative improvements in the American Shoulder and Elbow Surgeons score, the Western Ontario Rotator Cuff index, and shoulder range of motion were observed in both groups (all P <0.05). No statistically significant differences were identified between the acromioplasty and non-acromioplasty groups regarding postoperative functional outcomes, range of motion, complications, or magnetic resonance imaging–confirmed tendon integrity (all P >0.05). Conclusion: Concomitant acromioplasty during arthroscopic repair of small- to medium-sized degenerative RCTs offered no added functional or structural benefit.