Does acromioplasty enhance arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized trials
Bibliographic record
Abstract
BACKGROUND: Acromioplasty is frequently performed during arthroscopic rotator cuff repair (ARCR) to address subacromial impingement, though its clinical value remains debated. This meta-analysis examines whether acromioplasty improves functional outcomes, pain relief, or re-tear rates in patients undergoing ARCR for full-thickness rotator cuff tears. METHODS: A systematic search of PubMed, Embase, Cochrane Library, and Scopus was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify randomized controlled trials (RCTs) from 2011 to 2023. Six RCTs comparing ARCR with and without acromioplasty were included. Primary outcomes included functional scores of American Shoulder and Elbow Surgeons (ASES), Western Ontario Rotator Cuff Index, University of California, Los Angeles scores, pain levels (visual analog scale [VAS]), and re-tear rates. Data were pooled using a random-effects model. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Across 574 patients, both groups demonstrated improvement in functional outcomes. The acromioplasty group showed a modest advantage (e.g., ASES score: mean difference, 2.93), but these gains did not exceed the minimal clinically important difference. There were no significant differences in pain relief (as measured by VAS) or re-tear rates between groups. The risk of bias was moderate in some trials due to a lack of blinding. GRADE assessment rated evidence as high for ASES scores and moderate for other outcomes. CONCLUSIONS: Acromioplasty offers statistically modest improvements in shoulder function but does not meaningfully enhance pain relief or reduce re-tear rates. Given these findings, the routine use of acromioplasty in ARCR is not supported; however, select patients may benefit based on individual anatomical or clinical factors. Level of evidence: I.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.060 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.025 | 0.042 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".