Digitally Assisted Acromioplasty: The Effect of Interscalene Block on This New Surgical Technique.

Bain, G.I., Rudkin, G., Comley, A.S., Heptinstall, R.J., Chittleborough, M.

Purpose: Interscalene brachial plexus (ISBP) block has been shown to be safe and effective for shoulder surgery with significant benefits. The purpose of this study was to introduce the technique of digitally assisted acromioplasty and assess the effect of ISBP on rehabilitation.

Type of Study: Randomized controlled prospective trial.

Methods: In a randomized prospective trial of 40 patients undegoing acromioplasty under genera anaesthesia, 20 patients received an ISBP block (group 1) and 20 had no block (group 2). A digitally assited acromioplasty was performed using a burr introduced via a posterior portal. The undersurface of the acromion was debrided, directing the burr with the surgeonšs index finger introduced via a small lateral incision. Independent review was at day 1, day 2, week 1, week 6 and 1 year.

Results: Group 1 had significantly greater shoulder motion and shoulder score, and less pain and analgesic requirements on the first day. These differences did not persist. Both groups had improved pain and function over time compared with preoperative scores.

Conclusion: ISBP provides superior initla results but does not offer any significant persistent functional or rehabilatative advantage in the medium to long term. Digitally assisted acromioplasty is simple to perform and does not violate the deltoid insertion.

Arthroscopy. 2001; 17(1): 44-49