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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2016

01-07-2016 | Shoulder

Comparison of open acromioplasty, arthroscopic acromioplasty and physiotherapy in patients with subacromial impingement syndrome: a prospective randomised study

Authors: Stefanos Farfaras, Ninni Sernert, Erling Hallström, Jüri Kartus

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2016

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Abstract

Purpose

To compare the results two to three years after intervention, using either surgical or non-operative treatment.

Methods

Eighty-seven patients with subacromial impingement syndrome (SAIS) were randomised into open acromioplasty (OS group), arthroscopic acromioplasty (AS group) or physiotherapy (PT group) treatment. The assessments comprised the Constant score, the Watson and Sonnabend score, the SF-36 evaluation and a clinical examination performed by an independent observer. Fifty-five patients attended the clinical follow-up.

Results

The groups were comparable at baseline in terms of demographics and clinical assessments. No significant differences in terms of the clinical assessments or health-related quality of life (QoL) were found between the study groups at follow-up. The Constant score had improved significantly at follow-up in both the OS group and the AS group (p = 0.003 and 0.008, respectively). At follow-up, the OS group revealed improved strength compared with before intervention (p = 0.012). All groups revealed a significantly improved internal rotation (OSG p = 0.01, ASG p = 0.005, PTG p = 0.004). The SF-36 was significantly improved in some scales within all three groups. The Watson and Sonnabend score was significantly improved in 12/14 questions for the OS group, in 5/14 questions for the AS group and in 6/14 for the PT group (p < 0.02 OS group vs. AS group, p < 0.05 OS group vs. PT group).

Conclusion

In this randomised study, the Constant score, other clinical assessments and subjective health-related QoL revealed no significant differences between the 3 groups two to three years after intervention in patients with SAIS. The OS group showed a greater improvement over time.

Level of evidence

CT with low follow-up rate, Level II.
Literature
1.
Angst F, Schwyzer HK, Aeschlimann A, Simmen BR, Goldhahn J (2011) Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). Arthritis Care Res 63(Suppl 11):S174–S188CrossRef
2.
Biberthaler P, Beirer M, Kirchhoff S, Braunstein V, Wiedemann E, Kirchhoff C (2013) Significant benefit for older patients after arthroscopic subacromial decompression: a long-term follow-up study. Int Orthop 37(3):457–462CrossRefPubMedPubMedCentral
3.
Bot SD, van der Waal JM, Terwee CB, van der Windt DA, Schellevis FG, Bouter LM, Dekker J (2005) Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 64(1):118–123CrossRefPubMedPubMedCentral
4.
Brox JI, Gjengedal E, Uppheim G, Bohmer AS, Brevik JI, Ljunggren AE, Staff PH (1999) Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): a prospective, randomized, controlled study in 125 patients with a 2 1/2-year follow-up. J Shoulder Elb Surg 8(2):102–111CrossRef
5.
Böhmer AS (1984) Trening ved kroniske degenerative skulderlidelser. Fysioterapeuten 51:192–197
6.
Chipchase LS, O’Connor DA, Costi JJ, Krishnan J (2000) Shoulder impingement syndrome: preoperative health status. J Shoulder Elb Surg 9(1):12–15CrossRef
7.
Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed
8.
Davis AD, Kakar S, Moros C, Kaye EK, Schepsis AA, Voloshin I (2010) Arthroscopic versus open acromioplasty: a meta-analysis. Am J Sports Med 38(3):613–618CrossRefPubMed
9.
Dickens VA, Williams JL, Bhamra MS (2005) Role of physiotherapy in the treatment of subacromial impingement syndrome: a prospective study. Physiotherapy 91(3):159–164CrossRef
10.
Dorrestijn O, Stevens M, Winters JC, van der Meer K, Diercks RL (2009) Conservative or surgical treatment for subacromial impingement syndrome? A systematic review. J Shoulder Elb Surg 18(4):652–660CrossRef
11.
Ellman H (1987) Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy 3(3):173–181CrossRefPubMed
12.
13.
Faber E, Kuiper JI, Burdorf A, Miedema HS, Verhaar JA (2006) Treatment of impingement syndrome: a systematic review of the effects on functional limitations and return to work. J Occup Rehabil 16(1):7–25CrossRefPubMed
14.
Gajdosik RL, Bohannon RW (1987) Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther 67(12):1867–1872PubMed
15.
Gebremariam L, Hay EM, Koes BW, Huisstede BM (2011) Effectiveness of surgical and postsurgical interventions for the subacromial impingement syndrome: a systematic review. Arch Phys Med Rehabil 92(11):1900–1913CrossRefPubMed
16.
Haahr JP, Ostergaard S, Dalsgaard J, Norup K, Frost P, Lausen S, Holm EA, Andersen JH (2005) Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Ann Rheum Dis 64(5):760–764CrossRefPubMedPubMedCentral
17.
Holmgren T, Bjornsson Hallgren H, Oberg B, Adolfsson L, Johansson K (2012) Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study. BMJ 344:e787CrossRefPubMedPubMedCentral
18.
Holmgren T, Hallgren HB, Oberg B, Adolfsson L, Johansson K (2013) Republished research: Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study. Br J Sports Med 47(14):908CrossRefPubMed
19.
Husby T, Haugstvedt JR, Brandt M, Holm I, Steen H (2003) Open versus arthroscopic subacromial decompression: a prospective, randomized study of 34 patients followed for 8 years. Acta Orthop Scand 74(4):408–414CrossRefPubMed
20.
Jonsson P, Wahlstrom P, Ohberg L, Alfredson H (2006) Eccentric training in chronic painful impingement syndrome of the shoulder: results of a pilot study. Knee Surg Sports Traumatol Arthrosc 14(1):76–81CrossRefPubMed
21.
Kirkley A, Griffin S, Dainty K (2003) Scoring systems for the functional assessment of the shoulder. Arthroscopy 19(10):1109–1120CrossRefPubMed
22.
Klintberg IH, Svantesson U, Karlsson J (2010) Long-term patient satisfaction and functional outcome 8-11 years after subacromial decompression. Knee Surg Sports Traumatol Arthrosc 18(3):394–403CrossRefPubMed
23.
Kuhn JE (2009) Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elb Surg 18(1):138–160CrossRef
24.
Linsell L, Dawson J, Zondervan K, Rose P, Randall T, Fitzpatrick R, Carr A (2006) Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral. Rheumatology (Oxford, England) 45(2):215–221CrossRef
25.
Lunsjo K, Bengtsson M, Nordqvist A, Abu-Zidan FM (2011) Patients with shoulder impingement remain satisfied 6 years after arthroscopic subacromial decompression: a prospective study of 46 patients. Acta Orthop 82(6):711–713CrossRefPubMedPubMedCentral
26.
Michener LA, Walsworth MK, Burnet EN (2004) Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther 17(2):152–164CrossRefPubMed
27.
Neer CS 2nd (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54(1):41–50PubMed
28.
Ostor AJ, Richards CA, Prevost AT, Speed CA, Hazleman BL (2005) Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology (Oxford, England) 44(6):800–805CrossRef
29.
Park SI, Choi YK, Lee JH, Kim YM (2013) Effects of shoulder stabilization exercise on pain and functional recovery of shoulder impingement syndrome patients. J Phys Ther Sci 25(11):1359–1362CrossRefPubMedPubMedCentral
30.
Rockwood CA, Lyons FR (1993) Shoulder impingement syndrome: diagnosis, radiographic evaluation, and treatment with a modified Neer acromioplasty. J Bone Joint Surg Am 75(3):409–424PubMed
31.
Sullivan M, Karlsson J (1998) The Swedish SF-36 Health Survey III. Evaluation of criterion-based validity: results from normative population. J Clin Epidemiol 51(11):1105–1113CrossRefPubMed
32.
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483CrossRefPubMed
33.
Watson EM, Sonnabend DH (2002) Outcome of rotator cuff repair. J Shoulder Elb Surg 11(3):201–211CrossRef
34.
Yian EH, Ramappa AJ, Arneberg O, Gerber C (2005) The constant score in normal shoulders. J Shoulder Elb Surg 14(2):128–133CrossRef
35.
Yu E, Cil A, Harmsen WS, Schleck C, Sperling JW, Cofield RH (2010) Arthroscopy and the dramatic increase in frequency of anterior acromioplasty from 1980 to 2005: an epidemiologic study. Arthroscopy 26(9 Suppl):S142–S147CrossRefPubMedPubMedCentral
Metadata
Title
Comparison of open acromioplasty, arthroscopic acromioplasty and physiotherapy in patients with subacromial impingement syndrome: a prospective randomised study
Authors
Stefanos Farfaras
Ninni Sernert
Erling Hallström
Jüri Kartus
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3416-4

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