It seems that anterior acromioplasty described by Neer in 1972 has been accepted widely as a successful procedure for impingement syndromes in the shoulder especially in older individuals. We have also met with excellent results following the Neer procedure.
In this report we reviewed four shoulders of three patients which were reoperated on in accordance with Neer in our hospital more than six months before because of persistent impingement in spite of the previous one or two operations in other institutions and found following three points deserving of emphasis through the findings at the operation, reconfirming the effectiveness of the Neer procedure.
1) To minimize a damage to the function of the deltoid muscle, it is imperative that it should be detached or devided through an optimum approach and restored anatomically.
2) It should be recognized that the degenerated AC joint is an important contributor to rotator cuff impingement and that the anterior acromioplasty of Neer is not limited only to the coracoacromial arch when the AC joint is degenerated.
3) In younger patients with impingement, it is important to realize that it may be a continuum of some type of instabilities and that the impingement should never be surgically repaired without repairing the primary instability, if present.