Summary
The treatment of Os Acromiale improves the pain and function of the symptomatic patient. Osteosynthesis with a shroud yields better results than compression screws.
Abstract
The objective is to know the results of the treatment of symptomatic Os Acromiale in patients with/without complete rotator cuff tear.
Methods
A retrospective observational study was carried out with patients operated on for Os Acromiale, mesoacromion type (n=50) with intact rotator cuff (58%) and torn (42%), treated by combined arthroscopic-open technique (osteosynthesis), during a period of 25 years (1997-2022).
Demographic data, associated injuries, type of osteosynthesis, radiological union and clinical-functional result were analyzed. Statistical analysis was performed using the SPSS program.
Results
50 patients with symptomatic Os Acromiale. Mean age: 55 ± 10.49 (18-73) years and male predominance (60%). Mean follow-up time: 15.16 ± 6.63 months. 42% (21) required intraoperative treatment for complete cuff tear.
Radiological consolidation was achieved in 36 patients (72%), without union (12%) and not identified in the clinical history (16%). At the end of the follow-up, 88% showed normal function and 92% were pain-free.
Direct evaluation of function and pain was observed (p<0.0001), with no differences observed in patients with and without cuff tear (p>0.05). Patients with cuff tear were older (52.10 ± 11.15 vs. 59.52 ± 7.37, p< 0.05).
The increase in follow-up time was related to an increase in consolidation rates (10.42 ± 7.49 vs. 16.98 ± 5.36, p< 0.05).
The use of compression screws had a negative influence on pain and function (p<0.05), without modifying the consolidation rate (p>0.05). 4% of the patients (2) underwent salvage surgery for previous DSA and both evolved unfavorably. 48% of the patients required reintervention due to intolerance to the osteosynthesis material.
Conclusion
The treatment of Os Acromiale improves the pain and function of the symptomatic patient, with results maintained in the medium-long term. Osteosynthesis with a shroud yields better results than compression screws, presenting a high rate of reintervention due to minor complications, such as intolerance to the material.