Cost-Effectiveness of Rotator Cuff Repair With Concomitant Subacromial Decompression at Mid-Term Follow-Up…

Systematic reviewThe Journal of the American Academy of Orthopaedic Surgeons· Aug 2026

Cost-Effectiveness of Rotator Cuff Repair With Concomitant Subacromial Decompression at Mid-Term Follow-Up: A Systematic Review and Economic Analysis.

Rodrigo Saad Berreta, Daniel Badin, Henry Fox … Uma Srikumaran

Shoulder & ElbowSystematic reviewClinical practiceQ1IF 3.0

Adding decompression to rotator cuff repair favored as cost-effective in nearly all simulations

Cost-Effectiveness of Rotator Cuff Repair With Concomitant Subacromial Decompression at Mid-Term Follow-Up: A Systematic Review and Economic Analysis.

Rodrigo Saad Berreta … Uma Srikumaran

The Journal of the American Academy of Orthopaedic Surgeons · Aug 2026 · Q1 in Orthopedics

Background

There is limited evidence evaluating the cost-effectiveness of adding subacromial decompression (subacromial decompression) to rotator cuff repair (rotator cuff repair) in the treatment of full-thickness rotator cuff tears.

Purpose

The purpose of this study was to perform (1) a systematic review and (2) cost-utility analysis comparing isolated rotator cuff repair versus rotator cuff repair with subacromial decompression in patients with full-thickness rotator cuff tears.

Methods

A systematic review was conducted per Preferred Reporting Items for Systemactic reviews and Meta-Analyses (PRISMA) 2020 guidelines to identify Level I-II studies comparing rotator cuff repair and rotator cuff repair with subacromial decompression at ≥5-year follow-up.

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Results

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cost-effective choice in almost every simulation run, favoring decompression

More results

Over 5 years, rotator cuff repair with subacromial decompression had a lower mean cost ($33,448) compared with isolated rotator cuff repair ($34,593) and yielded slightly higher quality-adjusted life years (1.465 vs 1.454).

More results

Rotator cuff repair + subacromial decompression demonstrated a positive incremental net monetary benefit ($1,695) and a negative incremental cost-effectiveness ratio, emerging as the dominant strategy.

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Conclusion · 1 of 2

Despite higher upfront costs, subacromial decompression during rotator cuff repair remains cost-effective at mid-term follow-up.

Conclusion · 2 of 2

By reducing revision rates, subacromial decompression provides greater quality-adjusted life years at a lower overall cost compared with isolated rotator cuff repair.

Cost-Effectiveness of Rotator Cuff Repair With Concomitant Subacromial Decompression at Mid-Term Follow-Up: A Systematic Review and Economic Analysis.

Cost-Effectiveness of Rotator Cuff Repair With Concomitant Subacromial Decompression at Mid-Term Follow-Up: A Systematic Review and Economic Analysis.

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