Arthroscopically assisted internal fixation of the symptomatic unstable os acromiale with absorbable screws

• Published in: Journal of shoulder and elbow surgery 2012-12, Vol.21 (12), p.1740-1745
• Main Authors: Atoun, Ehud, MD, van Tongel, Alexander, MD, Narvani, Ali, FRCS (Orth & Tr), Rath, Ehud, MD, Sforza, Giuseppe, MD, Levy, Ofer, MD, MCh(Orth), FRCS
• Format: Article
• Language: English
• Subjects: Absorbable Implants; absorbable screws; Acromion - abnormalities; Acromion - surgery; Adult; Aged; arthroscopic; Arthroscopy - methods; Biological and medical sciences; Bone Screws; Diseases of the osteoarticular system; Female; fusion; Humans; Joint Instability - surgery; Male; Medical sciences; Middle Aged; Orthopedics; os acromiale; Retrospective Studies; Shoulder; Shoulder Joint - surgery
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2011.12.011

Background Symptomatic meso- type os acromiale is a common pathology with inconsistent outcomes of treatment with various surgical techniques. We report the outcome of a new technique for arthroscopic fusion of symptomatic os acromiale with absorbable screws. Materials and methods The study included 8 shoulders in 8 patients with symptomatic meso- type os acromiale who were treated with the use of a new technique for arthroscopic fusion with absorbable screws. The mean age was 54 years (range, 38-67 years), and the mean time from onset of symptoms to surgery was 18 months (range, 9-25 months). No patients reported a specific traumatic event before the onset of symptoms, and all noted the insidious onset of pain with no precipitating event. Results The average length of follow-up was 22 months (range, 12-36 month). The average Constant score improved from 49 points (range, 35-57 points) to 81 points (range, 75-86 points). The average satisfaction score improved from 4.5 of 10 (range, 2-6) to 8.5 of 10 (range 7-9). All patients made a good clinical recovery at 3 to 6 months after surgery. At the last follow-up, full radiographic union was observed in 6 patients, partial union in 1 patient, and persistent radiologic nonunion in 1 patient. Anterior bulging of the absorbable screws was noted in 2 patients, and the screws were trimmed 6 months after the first procedure. Conclusions We have found that this new arthroscopic technique of fixation of os acromiale with absorbable screws provides promising clinical, cosmetic, and radiologic results with high patient satisfaction.