Trial reportActa orthopaedica2015
Which patients do not recover from shoulder impingement syndrome, either with operative treatment or with nonoperative treatment?
Trial report in Acta orthopaedica, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness.Health technology assessment (Winchester, England) · 2023Pooled it
- Subacromial decompression surgery for rotator cuff disease.The Cochrane database of systematic reviews · 2019Pooled it
- Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs.British journal of sports medicine · 2017Pooled it
- Factors predicting long-term outcomes following physiotherapy in patients with subacromial pain syndrome: a secondary analysis.BMC musculoskeletal disorders · 2024Trial
- Specific exercises for subacromial pain.Acta orthopaedica · 2017Trial
- Trial
- No difference in long-term development of rotator cuff rupture and muscle volumes in impingement patients with or without decompression.Acta orthopaedica · 2016Trial
- Review
- MRI findings in atraumatic shoulder pain-patterns of disease correlated with age and gender.Irish journal of medical science · 2023Article
- Supraspinatus tendon thickness and subacromial impingement characteristics in younger and older adults.BMC musculoskeletal disorders · 2022Article
- Responsiveness and minimal important change of the Oxford Shoulder Score, EQ-5D, and the Fear-Avoidance Belief Questionnaire Physical Activity subscale in patients undergoing arthroscopic subacromial decompression.JSES international · 2021Article
- Arthroscopic bursectomy less effective in the degenerative shoulder with chronic subacromial pain.JSES international · 2021Article
- Radiofrequency microtenotomy: a promising method for treatment of rotator cuff tendinopathy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
- Article
- Shoulder MRI features with clinical correlations in subacromial pain syndrome: a cross-sectional and prognostic study.BMC musculoskeletal disorders · 2017Observational
- Is surgery for the subacromial pain syndrome ever indicated?Acta orthopaedica · 2015Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeShoulder impingement syndrome is common, but treatment is controversial. Arthroscopic acromioplasty is popular even though its efficacy is unknown. In this study, we analyzed stage-II shoulder impingement patients in subgroups to identify those who would benefit from the operation. PATIENTS AND
methodsIn a previous randomized study, 140 patients were either treated with a supervised exercise program or with arthroscopic acromioplasty followed by a similar exercise program. The patients were followed up at 2 and 5 years after randomization. Self-reported pain was used as the primary outcome measure.
resultsBoth treatment groups had less pain at 2 and 5 years, and this was similar in both groups. Duration of symptoms, marital status (single), long periods of sick leave, and lack of professional education appeared to increase the risk of persistent pain despite the treatment. Patients with impingement with radiological acromioclavicular (AC) joint degeneration also had more pain. The patients in the exercise group who later wanted operative treatment and had it did not get better after the operation.
interpretationThe natural course probably plays a substantial role in the outcome. Based on our findings, it is difficult to recommend arthroscopic acromioplasty for any specific subgroup. Regarding operative treatment, however, a concomitant AC joint resection might be recommended if there are signs of AC joint degeneration. Even more challenging for the development of a treatment algorithm is the finding that patients who do not recover after nonoperative treatment should not be operated either.
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