The end of an era?

In 1972, American orthopaedic surgeon Charles Neer published his seminal paper, “Anterior Acromioplasty for the Chronic Impingement Syndrome in the Shoulder: A Preliminary Report.” It wasn't a robust scientific paper; however, it changed the direction of orthopaedic practice for the next half century. Neer argued that a primary cause of shoulder pain was attrition of the supraspinatus tendon and related structures from the overlying acromion, especially when the arm was elevated. Neer recommended surgical removal to stop the impingement, and over the last half century, it could be argued that millions of people around the globe would have undergone acromioplasty surgery to stop this portion of the bone impinging onto the soft tissues located in the subacromial space. More recently, against the tide of subacromial decompression surgery there has been dissent, and the relationship between the acromion and symptoms has been challenged.