AAOS2017: Exercise therapy vs acromioplasty for shoulder impingement; 13-year follow-up

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
140 patients with shoulder impingement syndrome were randomized to acromioplasty followed by an exercise therapy program, or to an exercise therapy program alone. Patients were followed up for measures of patient-reported pain and disability over 11- to 13-year follow-up. Results demonstrated no Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
There has been an increasing trend in the number of clinical studies re-evaluating the role of a number of arthroscopic procedures in routine clinical practice and the treatment of a wide range of orthopaedic conditions. More specifically, there have been a number of recent studies evaluating whether outcomes differ between acromioplasty and exercise therapy in treatment of shoulder impingement syndrome. Studies with extended follow-up were needed to evaluate the therapeutic efficacy of these treatment options in the long-term.
What was the principal research question?
In the treatment of shoulder impingement syndrome, how does long-term outcome compare between exercise therapy alone and surgical decompression followed by exercise therapy?
Population: 140 patients with shoulder impingement syndrome (n=90 analyzed)
Intervention: Decompression and exercise therapy group: Participants underwent arthroscopic acromioplasty, followed by a supervised exercise therapy program.
Comparison: Exercise therapy alone group: Patients completed a supervised exercise therapy program.
Outcomes: The primary outcome was pain on a visual analog scale (VAS). Secondary outcomes were the Shoulder Disability Questionnaire (SDQ) score, ability to work, pain at night, and the number of days with pain in the previous 3 months prior to the follow-up visit.
Methods: RCT
Time: Follow-up ranged from 11 to 13 years post-intervention.
What were the important findings?
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What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.