Evidence map›Paper›PMID 34666734›Full record

Trial reportBMC musculoskeletal disorders2021

Return to work after subacromial decompression, diagnostic arthroscopy, or exercise therapy for shoulder impingement: a randomised, placebo-surgery controlled FIMPACT clinical trial with five-year follow-up.

Mathias Bäck, Mika Paavola, Pasi Aronen, Teppo L N Järvinen, Simo Taimela, Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators

2 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT00428870 naunknown statusnot on this map

Arthroscopic Decompression Versus Diagnostic Arthroscopy Without Subacromial Decompression Versus Supervised Exercise Therapy in Treatment of Subacromial Impingement Syndrome. A Blinded Randomized Controlled Trail.

TypeinterventionalSponsorUniversity of HelsinkiRan2005 to 2024Enrolled210ConditionsSubacromial Impingement SyndromeArmsArthroscopic acromioplasty or arthroscopy alone (sham) or conservative treatment (rehabilitation)
NCT07536009 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

"Effectiveness of a Telerehabilitation Program Versus a Conventional Rehabilitation Program in Patients With Subacromial Pain"

TypeinterventionalSponsorInstituto Mexicano del Seguro SocialRan2026 to 2027Enrolled82ConditionsSubacromial Impingement SyndromeArmsDigital Physical Therapy (Telerehabilitation), Conventional Physical Therapy
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Mathias BäckFinnish Centre for Evidence-Based Orthopaedics (FICEBO), Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Töölö Hospital, P.O. Box 266, 00029 HUS, Helsinki, Finland.
Mika PaavolaDepartment of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.
Pasi AronenBiostatistics Unit, Faculty of Medicine in the University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Teppo L N JärvinenFinnish Centre for Evidence-Based Orthopaedics (FICEBO), Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Töölö Hospital, P.O. Box 266, 00029 HUS, Helsinki, Finland.
Simo TaimelaFinnish Centre for Evidence-Based Orthopaedics (FICEBO), Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Töölö Hospital, P.O. Box 266, 00029 HUS, Helsinki, Finland. simo.taimela@helsinki.fi.
Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators
Helsinki University Hospital · FIUniversity of Helsinki · FITöölö Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundArthroscopic subacromial decompression is one of the most commonly performed shoulder surgeries in the world. It is performed to treat patients with suspected shoulder impingement syndrome, i.e., subacromial pain syndrome. Only few studies have specifically assessed return-to-work rates after subacromial decompression surgery. All existing evidence comes from open, unblinded study designs and this lack of blinding introduces the potential for bias. We assessed return to work and its predictors in patients with shoulder impingement syndrome in a secondary analysis of a placebo-surgery controlled trial.

methodsOne hundred eighty-four patients in a randomised trial had undergone arthroscopic subacromial decompression (n = 57), diagnostic arthroscopy, a placebo surgical intervention, (n = 59), or exercise therapy (n = 68). We assessed return to work, defined as having returned to work for at least two follow-up visits by the primary 24-month time point, work status at 24 and 60 months, and trajectories of return to work per follow-up time point. Patients and outcome assessors were blinded to the assignment regarding the arthroscopic subacromial decompression vs. diagnostic arthroscopy comparison. We assessed the treatment effect on the full analysis set as the difference between the groups in return-to-work rates and work status at 24 months and at 60 months using Chi-square test and the predictors of return to work with logistic regression analysis.

resultsThere was no difference in the trajectories of return to work between the study groups. By 24 months, 50 of 57 patients (88%) had returned to work in the arthroscopic subacromial decompression group, while the respective figures were 52 of 59 (88%) in the diagnostic arthroscopy group and 61 of 68 (90%) in the exercise therapy group. No clinically relevant predictors of return to work were found. The proportion of patients at work was 80% (147/184) at 24 months and 73% (124/184) at 60 months, with no difference between the treatment groups (p-values 0.842 and 0.943, respectively).

conclusionsArthroscopic subacromial decompression provided no benefit over diagnostic arthroscopy or exercise therapy on return to work in patients with shoulder impingement syndrome. We did not find clinically relevant predictors of return to work either.

trial registrationClinicalTrials.gov identifier NCT00428870 .

Indexed as

Shoulder Impingement SyndromeArthroscopyDecompression, SurgicalExercise TherapyFollow-Up StudiesHumansReturn to WorkShoulder PainTreatment OutcomeExercise therapyPlacebo surgeryRandomised controlled trialReturn to workSubacromial decompressionSubacromial pain

Identifiers

PMID34666734
PMCPMC8527687
OpenAlexW3207090800

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.