AAOS2017: Exercise therapy program vs acromioplasty for shoulder impingement; MRI results

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
CONFERENCE ACE REPORTS
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
Synopsis
140 patients with grade II shoulder impingement syndrome were randomized to either arthroscopic acromioplasty followed by a structured exercise therapy program or to a structured exercise therapy program alone. Patients underwent an MRI follow-up at 5 years to assess muscle volume change, the incidence of supraspinatus tendon rupture, and grade muscle fatty degeneration. 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?
Arthroscopic acromioplasty continues to be used in the management of patients with shoulder impingement even though recent evidence has suggested that this treatment provides no significant advantages in clinical and functional outcomes in comparison to exercise therapy. Proponents of this treatment have suggested that the benefit of acromioplasty may lie in preserving rotator cuff muscle integrity and volume. A randomized controlled trial was needed to evaluate outcomes on MRI following acromioplasty, as compared to exercise therapy alone.
What was the principal research question?
In patients with shoulder impingement syndrome, does arthroscopic acromioplasty significantly affect the rate of eventual rotator cuff tear on imaging, or volumes of the rotator cuff muscles, when compared to a structured exercise program alone over a 5-year follow-up?
Population: 140 patients with stage II shoulder impingement syndrome
Intervention: Acromioplasty + exercise group: Patients underwent arthroscopic acromioplasty, followed by an exercise therapy program. (n=70)
Comparison: Exercise alone group: Patients participated in structured exercise therapy program. (n=70)
Outcomes: MRI was performed to assess muscle volume change, the incidence of supraspinatus tendon rupture, and grade muscle fatty degeneration.
Methods: RCT
Time: MRI was performed at 5 year follow-up
What were the important findings?
CONTENT IS LOCKED
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.