Profile of Current Opinion on Arthroscopic Acromioplasty: A Video Survey Study

Danielle Y. Ponzio, Corinne VanBeek, Justin C. Wong, Eric M. Padegimas, Okechukwu A. Anakwenze, Charles L. Getz, Joseph A. Abboud, Stephen Brockmeier, Jack Kazanjian, Rhett Hobgood, George Athwal, Derek Cuff, Howard Routman, Jay Keener, Ryan Bicknell, Jason Stein, Anand Murthi, Paul Sethi, Greg Bauer, Caroline ChebliBrian Wolf, Cyrus Lashgari, April Armstrong, Quin Throckmorton, Marc Kowalsky, Michael Codsi, Jason Scalise, Jonathan Levy

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1253-1262
Number of pages10
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume32
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Decompression
Acromion
Expert Testimony
Elbow
Surgeons
Surveys and Questionnaires
Internet
Consensus
Decision Making
Pathology
Rotator Cuff Injuries
Therapeutics

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

Ponzio, D. Y., VanBeek, C., Wong, J. C., Padegimas, E. M., Anakwenze, O. A., Getz, C. L., ... Levy, J. (2016). Profile of Current Opinion on Arthroscopic Acromioplasty: A Video Survey Study. Arthroscopy - Journal of Arthroscopic and Related Surgery, 32(7), 1253-1262. https://doi.org/10.1016/j.arthro.2016.01.010
Ponzio, Danielle Y. ; VanBeek, Corinne ; Wong, Justin C. ; Padegimas, Eric M. ; Anakwenze, Okechukwu A. ; Getz, Charles L. ; Abboud, Joseph A. ; Brockmeier, Stephen ; Kazanjian, Jack ; Hobgood, Rhett ; Athwal, George ; Cuff, Derek ; Routman, Howard ; Keener, Jay ; Bicknell, Ryan ; Stein, Jason ; Murthi, Anand ; Sethi, Paul ; Bauer, Greg ; Chebli, Caroline ; Wolf, Brian ; Lashgari, Cyrus ; Armstrong, April ; Throckmorton, Quin ; Kowalsky, Marc ; Codsi, Michael ; Scalise, Jason ; Levy, Jonathan. / Profile of Current Opinion on Arthroscopic Acromioplasty : A Video Survey Study. In: Arthroscopy - Journal of Arthroscopic and Related Surgery. 2016 ; Vol. 32, No. 7. pp. 1253-1262.
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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.",
author = "Ponzio, {Danielle Y.} and Corinne VanBeek and Wong, {Justin C.} and Padegimas, {Eric M.} and Anakwenze, {Okechukwu A.} and Getz, {Charles L.} and Abboud, {Joseph A.} and Stephen Brockmeier and Jack Kazanjian and Rhett Hobgood and George Athwal and Derek Cuff and Howard Routman and Jay Keener and Ryan Bicknell and Jason Stein and Anand Murthi and Paul Sethi and Greg Bauer and Caroline Chebli and Brian Wolf and Cyrus Lashgari and April Armstrong and Quin Throckmorton and Marc Kowalsky and Michael Codsi and Jason Scalise and Jonathan Levy",
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Ponzio, DY, VanBeek, C, Wong, JC, Padegimas, EM, Anakwenze, OA, Getz, CL, Abboud, JA, Brockmeier, S, Kazanjian, J, Hobgood, R, Athwal, G, Cuff, D, Routman, H, Keener, J, Bicknell, R, Stein, J, Murthi, A, Sethi, P, Bauer, G, Chebli, C, Wolf, B, Lashgari, C, Armstrong, A, Throckmorton, Q, Kowalsky, M, Codsi, M, Scalise, J & Levy, J 2016, 'Profile of Current Opinion on Arthroscopic Acromioplasty: A Video Survey Study', Arthroscopy - Journal of Arthroscopic and Related Surgery, vol. 32, no. 7, pp. 1253-1262. https://doi.org/10.1016/j.arthro.2016.01.010

Profile of Current Opinion on Arthroscopic Acromioplasty : A Video Survey Study. / Ponzio, Danielle Y.; VanBeek, Corinne; Wong, Justin C.; Padegimas, Eric M.; Anakwenze, Okechukwu A.; Getz, Charles L.; Abboud, Joseph A.; Brockmeier, Stephen; Kazanjian, Jack; Hobgood, Rhett; Athwal, George; Cuff, Derek; Routman, Howard; Keener, Jay; Bicknell, Ryan; Stein, Jason; Murthi, Anand; Sethi, Paul; Bauer, Greg; Chebli, Caroline; Wolf, Brian; Lashgari, Cyrus; Armstrong, April; Throckmorton, Quin; Kowalsky, Marc; Codsi, Michael; Scalise, Jason; Levy, Jonathan.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 32, No. 7, 01.07.2016, p. 1253-1262.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Profile of Current Opinion on Arthroscopic Acromioplasty

T2 - A Video Survey Study

AU - Ponzio, Danielle Y.

AU - VanBeek, Corinne

AU - Wong, Justin C.

AU - Padegimas, Eric M.

AU - Anakwenze, Okechukwu A.

AU - Getz, Charles L.

AU - Abboud, Joseph A.

AU - Brockmeier, Stephen

AU - Kazanjian, Jack

AU - Hobgood, Rhett

AU - Athwal, George

AU - Cuff, Derek

AU - Routman, Howard

AU - Keener, Jay

AU - Bicknell, Ryan

AU - Stein, Jason

AU - Murthi, Anand

AU - Sethi, Paul

AU - Bauer, Greg

AU - Chebli, Caroline

AU - Wolf, Brian

AU - Lashgari, Cyrus

AU - Armstrong, April

AU - Throckmorton, Quin

AU - Kowalsky, Marc

AU - Codsi, Michael

AU - Scalise, Jason

AU - Levy, Jonathan

PY - 2016/7/1

Y1 - 2016/7/1

N2 - 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.

AB - 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.

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