Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review
Abstract Background This review compares the outcomes and complication rates of three surgical strategies used for the management of symptomatic os acromiale. The purpose of this study was to help guide best practice recommendations. Methods A systematic review of nine prospective studies, seven ret...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-018-1041-5 |
| _version_ | 1828154042353713152 |
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| author | Jennifer A. Purnell Jonathan Bourget-Murray Adam Kwapisz Aaron J. Bois Justin LeBlanc |
| author_facet | Jennifer A. Purnell Jonathan Bourget-Murray Adam Kwapisz Aaron J. Bois Justin LeBlanc |
| author_sort | Jennifer A. Purnell |
| collection | DOAJ |
| description | Abstract Background This review compares the outcomes and complication rates of three surgical strategies used for the management of symptomatic os acromiale. The purpose of this study was to help guide best practice recommendations. Methods A systematic review of nine prospective studies, seven retrospective studies, and three case studies published across ten countries between 1993 and 2018 was performed. Adult patients (i.e., ≥ 18 years of age) with a symptomatic os acromiale that failed nonoperative management were included in this review. Surgical techniques utilized within the included studies include excision, acromioplasty, and open reduction and internal fixation (ORIF). The primary outcomes of interest included patient satisfaction. Range of motion and several standardized outcome measurement tools were also included in the final analysis. Results Patient satisfaction was highest in the excision and ORIF groups, with 92% and 82% of patients reporting good to excellent postoperative results, respectively, compared to 63% in the acromioplasty group. All three patient groups experienced improvements in postoperative outcomes (i.e., active range of motion and patient-reported outcome scores). The excision group experienced a complication rate of 1%, while the acromioplasty group experienced a complication rate of 11% and the ORIF group a rate of 67%. Conclusion This study reports on the largest sample of patients who underwent surgical treatment for a symptomatic os acromiale. We have demonstrated that excision of the os with meticulous repair of the deltoid resulted in the best clinical outcomes with the least complications. In healthy adult patients with a large os fragment and a normal rotator cuff, surgical fixation may provide increased preservation of deltoid function while offering good to excellent patient satisfaction. However, patients must be informed that a second procedure may be required to remove symptomatic hardware. |
| first_indexed | 2024-04-11T22:34:31Z |
| format | Article |
| id | doaj.art-1de15dbd06dc4b70aeb83b653c3bd9b9 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:34:31Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-1de15dbd06dc4b70aeb83b653c3bd9b92022-12-22T03:59:15ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-01-011411810.1186/s13018-018-1041-5Clinical results and complications following surgical management of symptomatic os acromiale: a systematic reviewJennifer A. Purnell0Jonathan Bourget-Murray1Adam Kwapisz2Aaron J. Bois3Justin LeBlanc4Department of Surgery, Section of Orthopaedic Surgery, University of CalgaryDepartment of Surgery, Section of Orthopaedic Surgery, University of CalgaryClinic of Orthopaedics and Paediatric Orthopaedics, Medical University of ŁódźDepartment of Surgery, Section of Orthopaedic Surgery, University of CalgaryDepartment of Surgery, Section of Orthopaedic Surgery, University of CalgaryAbstract Background This review compares the outcomes and complication rates of three surgical strategies used for the management of symptomatic os acromiale. The purpose of this study was to help guide best practice recommendations. Methods A systematic review of nine prospective studies, seven retrospective studies, and three case studies published across ten countries between 1993 and 2018 was performed. Adult patients (i.e., ≥ 18 years of age) with a symptomatic os acromiale that failed nonoperative management were included in this review. Surgical techniques utilized within the included studies include excision, acromioplasty, and open reduction and internal fixation (ORIF). The primary outcomes of interest included patient satisfaction. Range of motion and several standardized outcome measurement tools were also included in the final analysis. Results Patient satisfaction was highest in the excision and ORIF groups, with 92% and 82% of patients reporting good to excellent postoperative results, respectively, compared to 63% in the acromioplasty group. All three patient groups experienced improvements in postoperative outcomes (i.e., active range of motion and patient-reported outcome scores). The excision group experienced a complication rate of 1%, while the acromioplasty group experienced a complication rate of 11% and the ORIF group a rate of 67%. Conclusion This study reports on the largest sample of patients who underwent surgical treatment for a symptomatic os acromiale. We have demonstrated that excision of the os with meticulous repair of the deltoid resulted in the best clinical outcomes with the least complications. In healthy adult patients with a large os fragment and a normal rotator cuff, surgical fixation may provide increased preservation of deltoid function while offering good to excellent patient satisfaction. However, patients must be informed that a second procedure may be required to remove symptomatic hardware.http://link.springer.com/article/10.1186/s13018-018-1041-5Os acromialeSymptomaticSurgical techniqueSurgical outcomesComplications |
| spellingShingle | Jennifer A. Purnell Jonathan Bourget-Murray Adam Kwapisz Aaron J. Bois Justin LeBlanc Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review Journal of Orthopaedic Surgery and Research Os acromiale Symptomatic Surgical technique Surgical outcomes Complications |
| title | Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review |
| title_full | Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review |
| title_fullStr | Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review |
| title_full_unstemmed | Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review |
| title_short | Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review |
| title_sort | clinical results and complications following surgical management of symptomatic os acromiale a systematic review |
| topic | Os acromiale Symptomatic Surgical technique Surgical outcomes Complications |
| url | http://link.springer.com/article/10.1186/s13018-018-1041-5 |
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