Profile of Current Opinion on Arthroscopic Acromioplasty: A Video Survey Study.
Arthroscopy
; 32(7): 1253-62, 2016 07.
Article
em En
| MEDLINE
| ID: mdl-27117824
ABSTRACT
PURPOSE:
To provide a baseline profile of current opinion on use of arthroscopic acromioplasty and evaluate the consistency of surgical decision making on whether or not to perform acromioplasty across different surgeon practices.METHODS:
Twenty-two fellowship-trained orthopaedic shoulder surgeons from the Association of Clinical Elbow and Shoulder Surgeons completed an Internet-based survey on practices associated with acromioplasty, including questions related to 15 arthroscopic videos. Based on video cases, interobserver and intraobserver agreement regarding clinically based decisions related to acromioplasty were assessed.RESULTS:
Acromioplasty was uncommonly performed in isolation among this group and was most commonly performed in conjunction with repair of full-thickness rotator cuff tears. Nineteen of 22 (86%) surgeons favored an arthroscopic approach for acromioplasty. Depth of bony resection was determined most commonly based on clinical judgment and experience (68%). The video portion of the survey revealed slight interobserver agreement for classification of acromion morphology (κ = 0.099), need for acromioplasty (κ = 0.020), and adequacy of decompression (κ = 0.1). In contrast, there was fair intraobserver reliability regarding acromion morphology (κ = 0.370) and decision whether to perform acromioplasty in a given case (κ = 0.348) whereas there was moderate intraobserver reliability in the presence of a reparable rotator cuff tear (κ = 0.507) and assessment of the adequacy of decompression (κ = 0.453).CONCLUSIONS:
Although surgeons had similarities regarding principles of acromioplasty, including indications, surgical approach, and technique, there was lack of consensus when surgeons reviewed the video of clinical cases. Although surgeons may have similar goals in terms of treatment of pathology related to subacromial impingement, individual surgeon thresholds for the need and adequacy of decompression are varied and are not standardized. LEVEL OF EVIDENCE Level V, expert opinion.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Acrômio
/
Atitude do Pessoal de Saúde
/
Tomada de Decisão Clínica
/
Cirurgiões Ortopédicos
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Arthroscopy
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Estados Unidos