Which patients do not recover from shoulder impingement syndrome, either with operative treatment or with nonoperative treatment?
DOI:
https://doi.org/10.3109/17453674.2015.1033309Abstract
Background and purpose — Shoulder impingement syndrome is common, but treatment is controversial. Arthroscopic acromioplasty is popular even though its efficacy is unknown. In this study, we analyzed stage-II shoulder impingement patients in subgroups to identify those who would benefit from the operation. Patients and methods — In a previous randomized study, 140 patients were either treated with a supervised exercise program or with arthroscopic acromioplasty followed by a similar exercise program. The patients were followed up at 2 and 5 years after randomization. Self-reported pain was used as the primary outcome measure. Results — Both treatment groups had less pain at 2 and 5 years, and this was similar in both groups. Duration of symptoms, marital status (single), long periods of sick leave, and lack of professional education appeared to increase the risk of persistent pain despite the treatment. Patients with impingement with radiological acromioclavicular (AC) joint degeneration also had more pain. The patients in the exercise group who later wanted operative treatment and had it did not get better after the operation. Interpretation — The natural course probably plays a substantial role in the outcome. Based on our findings, it is difficult to recommend arthroscopic acromioplasty for any specific subgroup. Regarding operative treatment, however, a concomitant AC joint resection might be recommended if there are signs of AC joint degeneration. Even more challenging for the development of a treatment algorithm is the finding that patients who do not recover after nonoperative treatment should not be operated either.Downloads
Download data is not yet available.
Downloads
Published
2015-11-02
How to Cite
Ketola, S., Lehtinen, J., Rousi, T., Nissinen, M., Huhtala, H., & Arnala, I. (2015). Which patients do not recover from shoulder impingement syndrome, either with operative treatment or with nonoperative treatment?. Acta Orthopaedica, 86(6), 641–646. https://doi.org/10.3109/17453674.2015.1033309
Issue
Section
Articles
License
![Creative Commons License](http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 Unported License.
Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.