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BMC Musculoskeletal Disorders

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Open Access 01-12-2007 | Study protocol

A new interdisciplinary treatment strategy versus usual medical care for the treatment of subacromial impingement syndrome: a randomized controlled trial

Authors: Oscar Dorrestijn, Martin Stevens, Ron L Diercks, Klaas van der Meer, Jan C Winters

Published in: BMC Musculoskeletal Disorders | Issue 1/2007

Abstract

Background

Subacromial impingement syndrome (SIS) is the most frequently recorded shoulder disorder. When conservative treatment of SIS fails, a subacromial decompression is warranted. However, the best moment of referral for surgery is not well defined. Both early and late referrals have disadvantages – unnecessary operations and smaller improvements in shoulder function, respectively. This paper describes the design of a new interdisciplinary treatment strategy for SIS (TRANSIT), which comprises rules to treat SIS in primary care and a well-defined moment of referral for surgery.

Methods/Design

The effectiveness of an arthroscopic subacromial decompression versus usual medical care will be evaluated in a randomized controlled trial (RCT). Patients are eligible for inclusion when experiencing a recurrence of SIS within one year after a first episode of SIS which was successfully treated with a subacromial corticosteroid injection. After inclusion they will receive injection treatment again by their general practitioner. When, after this treatment, there is a second recurrence within a year post-injection, the participants will be randomized to either an arthroscopic subacromial decompression (intervention group) or continuation of usual medical care (control group). The latter will be performed by a general practitioner according to the Dutch National Guidelines for Shoulder Problems. At inclusion, at randomization and three, six and 12 months post-randomization an outcome assessment will take place. The primary outcome measure is the patient-reported Shoulder Disability Questionnaire. The secondary outcome measures include both disease-specific and generic measures, and an economic evaluation. Treatment effects will be compared for all measurement points by using a GLM repeated measures analyses.

Discussion

The rationale and design of an RCT comparing arthroscopic subacromial decompression with usual medical care for subacromial impingement syndrome are presented. The results of this study will improve insight into the best moment of referral for surgery for SIS.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/8/15/prepub

Title: A new interdisciplinary treatment strategy versus usual medical care for the treatment of subacromial impingement syndrome: a randomized controlled trial
Authors: Oscar Dorrestijn
Martin Stevens
Ron L Diercks
Klaas van der Meer
Jan C Winters
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2007
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-8-15

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A new interdisciplinary treatment strategy versus usual medical care for the treatment of subacromial impingement syndrome: a randomized controlled trial

Abstract

Background

Methods/Design

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods/Design

Discussion

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