Rotator Cuff Repair With Acromioplasty Is Associated With an Increased Rate of Revision and Subsequent Procedures

PURPOSE: To evaluate the mid-term rate of revision arthroscopic rotator cuff repair as well as ipsilateral shoulder reoperations after index rotator cuff repair performed with or without acromioplasty in the United States. METHODS: The Medicare Standard Analytic File, which encompasses the entire Medicare billing and payment data, was queried between 2005 and 2014. Patients undergoing arthroscopic rotator cuff repair were identified and stratified based on whether ipsilateral acromioplasty was concurrently performed using Current Procedural Terminology codes. Groups were matched by age, sex, year of index procedure, and Elixhauser index at a 2:1 ratio. Primary end point was defined as undergoing a repeat ipsilateral shoulder surgery related to the rotator cuff at 5 years of follow-up. Kaplan–Meier survival curves were constructed, and the 2 groups were compared using the log-rank test. RESULTS: After matching, 54,209 shoulders in the rotator cuff repair with acromioplasty group and 26,448 shoulders in the rotator cuff repair without acromioplasty group were identified. Shoulders undergoing concurrent acromioplasty at index rotator cuff repair had a significantly increased rate of repeat ipsilateral cuff repair at 5 years postoperatively (8.5% vs 6.8%, P < .001). Similarly, there was an increased rate of reoperation of all types to the ipsilateral shoulder in cases where concurrent acromioplasty was performed (9.6% vs 9.1%, P < .001). CONCLUSIONS: Using a large, national database, concurrent acromioplasty at the time of rotator cuff tear was found to be associated with both an increase rate of overall subsequent procedures and revision rotator cuff repair. LEVEL OF EVIDENCE: III, retrospective comparative study.