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Abstract This study included sixty patients with mean age of 52.07 ± 8.48 years. Seventy percent of the subjects were females while thirty percent were males. The patients were divided into two groups. In group 1, arthroscopic rotator cuff repair and subacromial decompression were done, consisting of subacromial bursectomy, release of the CA ligament and anterior-inferior acromioplasty; while in group 2, only subacromial bursectomy was done in addition to arthroscopic repair of rotator cuff tear. Both groups were compared after at least 1 year regarding functional outcome using Modified University of California-Los Angeles (UCLA) score, the quality of life using DASH score, the extent of pain using the visual analogue scale (VAS) and the rate of complications. According to this current study, there is no statistically significant difference between arthroscopic repair of rotator cuff tears with subacromial decompression and without as regard the functional outcome using modified UCLA score (p=0.267), the satisfaction rate using DASH score (p=0.163), extent of pain using VAS (p=0.283) and complication rate (p=0.131). These results are comparable with other papers in literature. Waterman et al.(75) conducted a prospective, randomized controlled trial to assess the long-term efficacy of acromioplasty in conjunction with arthroscopic rotator cuff repair. Between 2007 and 2011, patients with full-thickness rotator cuff tear, irrespective of acromial morphology, were randomly allocated to undergo either acromioplasty or not as part of their repair procedure. The acromioplasty group comprised 32 participants with a mean age of 56.9 years, while the non-acromioplasty group encompassed 37 participants with an average age of 59.6 years. Following a mean follow-up period of 7.5 years, the study demonstrated no statistically significant differences between the two groups in terms of validated patient-reported outcomes assessed through various instruments such as the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), University of California-Los Angeles (UCLA) score (p=0.19), Visual Analog Scale (VAS) for pain (p=0.79), and the Constant score. Additionally, the rates of retear and revision surgery were comparable between both groups. Longo et al.(67) performed a retrospective clinical study to analyse the difference between the results of rotator cuff repair (RCR), with and without SAD. The study included 107 patients affected with rotator cuff tear. In 54 subjects, rotator cuff repair and subacromial decompression were done (group A), while in 53 subjects, only repair of rotator cuff was done (group B). The principal finding of that study after at least 5 years of follow up that the patients who did rotator cuff repair without subacromial decompression showed significantly superior long-term clinical outcomes using modified UCLA score (p=0.04), Wolfgang criteria, and Oxford Shoulder Score (OSS) score, when compared with patients who did RCR with subacromial decompression. Cheng et al.(76) conducted a systematic review and meta-analysis to compare the effectiveness of arthroscopic rotator cuff repair with and without subacromial decompression. The study included six randomized controlled trials and one cohort study, involving a total of 651 patients. The findings revealed a statistically significant difference in the American Shoulder and Elbow Surgeons (ASES) score, indicating improved patient-reported outcomes when subacromial decompression was performed alongside rotator cuff repair. However, no significant differences were observed for other scores, including the Constant score, University of California-Los A |