Review ArticlesManagement of the Failed Arthroscopic Subacromial Decompression: Causation and TreatmentDopirak, Ryan MD*; Ryu, Richard K.N. MD†Author Information *Lakeshore Orthopaedics, Manitowoc, WI †Private Practice, Micheltorena, Santa Barbara, CA Reprints: Ryan Dopirak, MD, Lakeshore Orthopaedics, Holy Family Memorial Hospital, 1650 S 41st Street, Manitowoc, WI 54220 (e-mail: firstname.lastname@example.org). Disclosures: Dr Ryu, Surgical Advisory Board for KFx; Consultant, Medbridge; Lecture/honorarium, Mitek. Dr Dopirak: Consultant for Conmed Linvatec. No conflict of interest regarding the material included in this study. Sports Medicine and Arthroscopy Review: September 2010 - Volume 18 - Issue 3 - p 207-212 doi: 10.1097/JSA.0b013e3181eb6ce8 Buy Metrics Abstract Arthroscopic subacromial decompression is an effective treatment for impingement syndrome, with published success rates between 77% and 90%. Failure of subacromial decompression is defined as persistent pain and disability after surgery despite adequate postoperative rehabilitation. Potential causes of failure after subacromial decompression are varied and may include technical error, incorrect diagnosis, inadequate rehabilitation, or unrealistic postoperative expectations. A methodical approach to the patient with persistent symptoms after subacromial decompression will allow for accurate diagnosis and treatment of the underlying problem in the majority of cases. © 2010 Lippincott Williams & Wilkins, Inc.