Should We be Routinely Performing Arthroscopic Subacromial Decompression During Rotator Cuff Repair (RCR)?

Volume 6 | Issue 1 | January-June 2021 | Page 48-51 | Sachin Kumar, Rajiv Gogna, Daniel Morris, Amol Tambe

Author: Sachin Kumar [1] , Rajiv Gogna [1] , Daniel Morris [1] , Amol Tambe [1]

[1] Derby Shoulder Unit, Royal Derby Hospital, Derby, UK.

Address of Correspondence:
Dr. Amol Tambe,
Consultant, Upper Limb Surgeon, Derby Shoulder Unit, Royal Derby
Hospital, Derby, UK.


Symptomatic rotator cuff tears cause pain and impaired function. Arthroscopic rotator cuff repair is an established treatment when nonoperative management fails. However, debate exists regarding the requirement of concurrent subacromial decompression. This review aims to answer pertinent questions and outline relevant literature in the role of arthroscopic subacromial decompression in rotator cuff repair.
Keywords: Decompression, Cuff, Arthroscopic, Repair.


  1. Luime J, Koes B, Hendriksen I, Burdorf A, Verhagen A, Miedema H, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004;33(2):73–81.
  2. Van der Windt D, Koes B, Boeke A. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pr. 1996;46(410):519–23.
  3. Micallef J, Pandya J, Low AK. Management of rotator cuff tears in the elderly population. Maturitas [Internet]. 2019 May;123:9–14.
  4. Mather RC, Koenig L, Acevedo D, Dall TM, Gallo P, Romeo A, et al. The Societal and Economic Value of Rotator Cuff Repair. J Bone Jt Surg [Internet]. 2013 Nov;95(22):1993–2000.
  5. Codman E. The Shoulder: Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Boston: Thomas Todd Co.; 1934. 1869–1940 p.
  6. Gartsman GM, O’Connor DP. Arthroscopic rotator cuff repair with and without arthroscopic subacromial decompression: a prospective, randomized study of one-year outcomes. J Shoulder Elb Surg [Internet]. 2004 Jul;13(4):424–6.
  7. Neer C, Poppen N. Supraspinatus outlet. Orthop Trans. 1987;(11):234.
  8. Bigliani L, Morrison D, April E. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;(10):228.
  9. Sela Y, Eshed I, Shapira S, Oran A, Vogel G, Herman A, et al. Rotator cuff tears: correlation between geometric tear patterns on MRI and arthroscopy and pre- and postoperative clinical findings. Acta radiol [Internet]. 2015 Feb;56(2):182–9.
  10. Gotoh M, Hamada K, Yamakawa H, Inoue A, Fukuda H. Increased substance P in subacromial bursa and shoulder pain in rotator cuff diseases. J Orthop Res [Internet]. 1998 Sep;16(5):618–21.
  11. Beard DJ, Rees JL, Cook JA, Rombach I, Cooper C, Merritt N, et al. Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial. Lancet [Internet]. 2018 Jan;391(10118):329–38.
  12. Milano G, Grasso A, Salvatore M, Zarelli D, Deriu L, Fabbriciani C. Arthroscopic Rotator Cuff Repair With and Without Subacromial Decompression: A Prospective Randomized Study. Arthrosc J Arthrosc Relat Surg [Internet]. 2007 Jan;23(1):81–8.
  13. Xue G, Chahal K, Lim T, Hu S, Li S, Liu J. Titanium mini locking plate with trans-osseous sutures for the treatment of humeral greater tuberosity fracture osteosynthesis versus PHILOS: a retrospective view. Int Orthop. 2018;42(10):2467–73.
  14. Galliera E, Randelli P, Dogliotti G, Dozio E, Colombini A, Lombardi G, et al. Matrix metalloproteases MMP-2 and MMP-9: Are they early biomarkers of bone remodelling and healing after arthroscopic acromioplasty? Injury [Internet]. 2010 Nov;41(11):1204–7.
  15. Randelli P, Margheritini F, Cabitza P, Dogliotti G, Corsi MM. Release of growth factors after arthroscopic acromioplasty. Knee Surgery, Sport Traumatol Arthrosc [Internet]. 2009 Jan 31;17(1):98–101.
  16. MacDonald P, McRae S, Leiter J, Mascarenhas R, Lapner P. Arthroscopic Rotator Cuff Repair with and without Acromioplasty in the Treatment of Full-Thickness Rotator Cuff Tears. J Bone Jt Surgery-American Vol [Internet]. 2011 Nov;93(21):1953–60.
  17. Abrams GD, Gupta AK, Hussey KE, Tetteh ES, Karas V, Bach BR, et al. Arthroscopic Repair of Full-Thickness Rotator Cuff Tears With and Without Acromioplasty. Am J Sports Med [Internet]. 2014 Jun 14;42(6):1296–303.
  18. Song L, Miao L, Zhang P, Wang W-L. Does concomitant acromioplasty facilitate arthroscopic repair of full-thickness rotator cuff tears? A meta-analysis with trial sequential analysis of randomized controlled trials. Springerplus [Internet]. 2016 Dec 21;5(1):685.
  19. Shin S-J, Oh JH, Chung SW, Song MH. The Efficacy of Acromioplasty in the Arthroscopic Repair of Small- to Medium-Sized Rotator Cuff Tears Without Acromial Spur: Prospective Comparative Study. Arthrosc J Arthrosc Relat Surg [Internet]. 2012 May;28(5):628–35.
  20. Tetteh E, Hussey KE, Abrams GD, Gupta AK, Dhawan A, Karas V, et al. A Prospective Randomized Trial of Functional Outcomes Following Rotator Cuff Repair With and Without Acromioplasty. Orthop J Sport Med [Internet]. 2013 Sep;1(4_suppl):2325967113S0010.
  21. Cheng C, Chen B, Xu H, Zhang Z, Xu W. Efficacy of concomitant acromioplasty in the treatment of rotator cuff tears: A systematic review and meta-analysis. van der Linde JA, editor. PLoS One [Internet]. 2018 Nov 15;13(11):e0207306.

22. Dabija DI, Jain NB. Minimal Clinically Important Difference of Shoulder Outcome Measures and Diagnoses. Am J Phys Med Rehabil [Internet]. 2019 Aug;98(8):671–6.

How to Cite this article: Kumar S, Gogna R, Morris D, Tambe A | Should We be Routinely  Performing
Arthroscopic Subacromial Decompression During Rotator Cuff Repair (RCR)?| Asian
Journal of Arthroscopy | January- June 2021; 6(1): 48-51.

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