Prevalence of Rotator Cuff Repairs with and Without Concomitant Subacromial Decompressions Has Not Changed



Recent research from the American Board of Orthopaedic Surgery database indicates a decreasing rate of subacromial decompression (SAD) performed with rotator cuff repair (RCR) by younger orthopedic surgeons.


The purpose of this study was to determine the rate of RCR with and without SAD and whether the rate of RCR with SAD decreased over time. Further, we set out to determine if there was significant variation in the rate of RCR with SAD by state.


Rates of RCR with and without open or arthroscopic SAD from 2010 to 2012 were determined based upon de-identified data from a national health insurance carrier. Data were normalized per 10,000 insured patients for comparative analysis.


Rates of RCR with concomitant SAD were higher than RCR without SAD in each year analyzed. In patients 50 years old and older, this same significant difference was also seen for each year. The rate of RCR with or without SAD did not decrease over the 3-year time period. The rate of RCR performed concomitantly with SAD was significantly higher than RCR performed without SAD in all patient age groups combined. There was wide variation in the rate of RCR with or without concurrent SAD across states.


Disproving our hypothesis, the overall rate of RCR with or without SAD did not decrease over the period from 2010 to 2012. There was wide variation in the rate of RCR by state; however, this variation was not seen in the incidence of SAD performed concomitant with the RCR.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2


  1. 1.

    Abrams GD, Gupta AK, Hussey KE, Tetteh ES, Karas V, Bach BR, Jr, C, et al. Arthroscopic repair of full-thickness rotator cuff tears with and without acromioplasty: randomized prospective trial with 2-year follow-up. Am J Sports Med. 2014;6:1296–1303.

    Article  Google Scholar 

  2. 2.

    American Academy of Orthopaedic Surgeons, Department of Research and Scientific Affairs. Orthopaedic practice in the U.S. 2010. Orthopaedic Surgeon Census Report. Rosemont: American Academy of Orthopaedic Surgeons.

  3. 3.

    American Medical Association. CPT 2012 Standard Edition. 1st ed. Chicago: American Medical Association Press; 2011.

  4. 4.

    Gartsman GM, Khan M, Hammerman SM. Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 1998;6:832–840.

  5. 5.

    Kesmezacar H, Akgun I, Ogut T, Gokay S, Uzun I. The coracoacromial ligament: the morphology and relation to rotator cuff pathology. J Shoulder Elbow Surg. 2008;1:182–188.

    Article  Google Scholar 

  6. 6.

    Mauro CS, Jordan SS, Irrgang JJ, Harner CD. Practice patterns for subacromial decompression and rotator cuff repair: an analysis of the American Board of Orthopaedic Surgery database. J Bone Joint Surg Am. 2012;16:1492–1499.

    Article  Google Scholar 

  7. 7.

    Milano G, Grasso A, Salvatore M, Zarelli D, Deriu L, Fabbriciani C. Arthroscopic rotator cuff repair with and without subacromial decompression: a prospective randomized study. Arthroscopy. 2007;1:81–88.

    Article  Google Scholar 

  8. 8.

    Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;1:41–50.

    Article  Google Scholar 

  9. 9.

    Shin SJ, Oh JH, Chung SW, Song MH. The efficacy of acromioplasty in the arthroscopic repair of small- to medium-sized rotator cuff tears without acromial spur: prospective comparative study. Arthroscopy. 2012;5:628–635.

    Article  Google Scholar 

  10. 10.

    Zhang AL, Montgomery SR, Ngo SS, Hame SL, Wang JC, Gamradt SC. Analysis of rotator cuff repair trends in a large private insurance population. Arthroscopy. 2013;4:623–629.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Daniel D. Buss MD.

Ethics declarations

Conflict of Interest

Ned Tervola, MA, ATC; L. Pearce McCarty III, MD; and M. Russell Giveans, PhD, declare that they have no conflicts of interest. Daniel D. Buss, MD, reports that he serves as a member of the UnitedHealthCare Scientific Advisory Board. Steve H. Stern, MD, reports that he is an employee of UnitedHealth Group.

Human/Animal Rights


Informed Consent

Informed consent was waived from all patients for being included in this study.

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Additional information

Level of Evidence: Therapeutic Study: Level IV

Electronic supplementary material


(PDF 1224 kb)


(PDF 1224 kb)


(PDF 1224 kb)


(PDF 1224 kb)


(PDF 1224 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Buss, D.D., Stern, S.H., Tervola, N. et al. Prevalence of Rotator Cuff Repairs with and Without Concomitant Subacromial Decompressions Has Not Changed. HSS Jrnl 14, 123–127 (2018).

Download citation


  • subacromial decompression
  • rotator cuff repair
  • variation
  • rate
  • geography
  • age