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Patients in Epsom & Ewell considering Shoulder surgery ?

NEW YORK (Reuters Health) – Subacromial decompression is no better than diagnostic arthroscopy for treating shoulder impingement, according to a recent study.

As many as 70% of patients with shoulder pain have shoulder impingement syndrome, which is commonly treated by arthroscopic subacromial decompression (ASD) of the passage of the rotator-cuff tendon. Although this is one of the most frequently performed orthopedic procedures in the world, it remains uncertain whether it actually benefits patients.

Dr. Mika Paavola from Helsinki University Hospital in Finland and colleagues assessed the efficacy of ASD (versus diagnostic arthroscopy alone) in a randomized controlled trial of 122 adult patients with shoulder symptoms consistent with shoulder impingement syndrome that were unresponsive to conventional conservative treatment.

From baseline to 24 months, the primary outcomes of pain at rest and pain on arm activity improved markedly and to a similar extent in both the ASD and diagnostic arthroscopy groups, the team reports in The British Medical Journal, online July 19.

At follow-up, the groups did not differ in any of the secondary outcomes, including functional measures, return to previous leisure activities, satisfaction with treatment, quality of life, complications, or adverse effects.

“The results of this randomized, placebo surgery controlled trial show that arthroscopic subacromial decompression provides no clinically relevant benefit over diagnostic arthroscopy in patients with shoulder impingement syndrome,” the researchers conclude. “The findings do not support the current practice of performing subacromial decompression in patients with shoulder impingement syndrome.”

Dr. Eivind Inderhaug from Haraldsplass Deaconess Hospital and the University of Bergen, in Norway, who has studied the procedure, told Reuters Health by email, “This study adds to the evidence that ASD should not be a first line of treatment for subacromial pain syndrome and that resources need to be allocated to facilitate better systems for providing early exercise intervention.

Richard Katesmark from the Epsom & Ewell Osteopathic Clinic comments;

“ Shoulder pain related to the Subacromial joint -be it tendon tears/irritation, bursitis, or impingement mentioned above- is one of the most common problems seen at my clinic. Whilst surgery has a place in the most severe examples, accurate diagnosis followed by appropriate expert manual treatment (including exercises) is effective in most cases. However patients should be aware that it is rarely a quick fix & can take several weeks for significant improvement to occur .