Many therapeutic questions and controversies surround the impingement syndrome of the shoulder, however it appears that the major procedure is rotator cuff decompression. This is achieved by antero-inferior acromioplasty and section of the coracoacromial ligament, during open or arthroscopic surgery. Which patients will be helped by this procedure? When does the surgical decision have to be taken? Is the suture of the rotator cuff tear and the removal of intratendinous calcifications needed in addition to the acromioplasty? Many major questions remain unanswered.
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