Acromion reconstruction after total arthroscopic acromionectomy: Salvage procedure using a bone graft

We report 2 cases of acromion reconstruction with a bone graft as a salvage procedure after total arthroscopic acromionectomy. Complete removal of the acromion had produced severe shoulder abnormality with pain and joint stiffness. We present the operative technique of acromion reconstruction using a corticocancellous bone graft from the iliac crest. Recreation of the acromion as a fulcrum of the shoulder joint as well as an important physiological insertion area for the deltoid muscle markedly improved pain and range of motion in these patients. In conclusion, based on these cases, we believe that total acromionectomy is an inadequate procedure for treatment of shoulder impingement syndrome. Acromion reconstruction with a bone graft is an alternative that may lead to improvement of clinical symptoms.