Arthroscopic subacromial decompression with and without the Holmium:YAG-laser. A prospective comparative study.

Abstract

The purpose of this study was to critically evaluate the results of laser-assisted arthroscopic subacromial decompression (ASD) and compare them with the results of a conventional arthroscopic procedure. In a prospective study, 52 patients with stage II and III (partial tear) impingement syndrome undergoing ASD were divided into two consecutive groups. The first 18 patients underwent conventional arthroscopic surgery using shaver and electrocautery (group S). The following 34 patients underwent ASD with the Holmium:YAG-laser (22 watt) and without electrocautery (group L). Subjective, objective, and functional results were assessed using the constant score preoperatively and postoperatively at specific intervals up to 1 year. The greatest improvement in the laser group was seen in the areas of pain with activity, pain at night, activity and movement at 1 week and at 6 weeks. The patients in group L also showed significantly better values for abduction power (P < .05). There were no complications in either group. Radiographic evaluation with the outlet view, preoperatively and postoperatively, showed an adequate bone resection in all cases. The postoperative Constant score for group L was significantly better. The average score increased from 54.7 to 79.8 in group L and from 50.3 to 68.7 in group S. Because of the low level of postoperative pain, the absence of adhesions and the almost complete lack of swelling, the patients in group L were able to regain full range of shoulder motion sooner than those in group S.