Management of symptomatic os acromiale: a survey of the American shoulder and elbow surgeons

  • Steven Horton
  • Michael P. Smuda
  • Julio J. Jauregui
  • Vidushan Nadarajah
  • Mohit N. Gilotra
  • Ralph Frank HennIII
  • Syed Ashfaq HasanEmail author
Original Paper



The purpose of this paper was to survey members of the American Shoulder and Elbow Surgeons (ASES) to assess their opinion on management options, help highlight important clinical factors, and elucidate surgical preferences for the treatment of a symptomatic meso-os.


An online questionnaire was distributed to the active members of the ASES. The survey queried surgeon demographics and perioperative management preferences, and presented multiple clinical case scenarios of patients with a presumed symptomatic, unstable os acromiale.


There were 116 ASES members who responded to the survey, and 26% (n = 30) who stated they do not operatively manage a symptomatic os. We identified two main clusters of respondents. Cluster 1 (n = 67) (as compared to cluster 2, n = 19) was comprised of surgeons with significantly more experience treating a symptomatic os acromiale (p < 0.05). These surgeons regarded gender, age, BMI, and hand dominance as important clinical factors when deciding when to proceed to surgery. Overall, arthroscopic management of the os was preferred, but those surgeons more experienced in treating os acromiale preferred open reduction and internal fixation (ORIF) in specific clinical cases.


The survey findings reflect the current lack of consensus in the treatment of a unstable, symptomatic os acromiale. Overall, arthroscopic management was preferred by most surgeons, though ORIF was preferred in certain clinical scenarios by those more experienced with os acromiale. The overall preference for arthroscopy suggests a possible shift in the treatment paradigm for patients with symptomatic meso-acromions, but higher level studies are needed to substantiate these findings.


Os acromiale Arthroscopy Open reduction internal fixation Survey Shoulder Experts 


Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.


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© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of OrthopaedicsSUNY Downstate College of MedicineBrooklynUSA

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