Conservative or surgical treatment for subacromial impingement syndrome? A systematic review

Dorrestijn, Oscar; Stevens, Martin; Winters, Jan C.; Meer, Klaas van der; Diercks, Ron L.

doi:10.1016/j.jse.2009.01.010

Cited by 166 publications

(121 citation statements)

References 42 publications

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“…In a recent review and meta-analysis, the evidence on effectiveness of operative or nonoperative treatment was found to be limited (Saltychev et al 2015). This is in keeping with the Cochrane Collaboration report (Coghlan et al 2008) and 2 previous reviews (Dorrestijn et al 2009, Gebremariam et al 2011). …”

Section: Discussionsupporting

confidence: 89%

“…Both nonoperative treatment and operative treatment have been used to treat this syndrome (Coghlan et al 2008, Dorrestijn et al 2009, Kromer et al 2009, Chaudhury et al 2010). It has been shown that arthroscopic acromioplasty is not superior to a supervised exercise program (Ketola et al 2009, 2013, Papadonikolakis et al 2011, Diercks et al 2014, Saltychev et al 2015).…”

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confidence: 99%

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Which patients do not recover from shoulder impingement syndrome, either with operative treatment or with nonoperative treatment?

et al. 2015

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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.

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Section: Discussionsupporting

confidence: 89%

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confidence: 99%

Which patients do not recover from shoulder impingement syndrome, either with operative treatment or with nonoperative treatment?

et al. 2015

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“…Currently, the effect of physiotherapy on clinical outcomes in patients with shoulder disorders are unclear, with systematic reviews reporting divergent findings (Dorrestijn et al , 2009, Ho et al , 2009, Michener et al , 2004, van den Dolder et al , 2012. It is challenging to determine effects of physical modalities (e.g., exercise, manual therapy, electrotherapy) on clinical outcomes in multimodal randomized controlled trials (RCTs).…”

Section: Introductionmentioning

confidence: 99%

The initial effects of a sustained glenohumeral postero-lateral glide during elevation on shoulder muscle activity: A repeated measures study on asymptomatic shoulders

et al. 2016

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“…Regarding SIS therapy, several authors reported in the past that physiotherapy aimed at strengthening of the muscular motors and stabilisers of the shoulder joint renders satisfactory results especially in patients aged under 60 and represents a cost-effective treatment [12,13]. In contrast, for those individuals resistant to physical therapy, arthroscopic subacromial decompression (ASD) is the most successful surgical procedure providing clear benefits [1,11,14].…”

Section: Introductionmentioning

confidence: 99%

Significant benefit for older patients after arthroscopic subacromial decompression: a long-term follow-up study

Biberthaler¹,

Beirer²,

Kirchhoff³

et al. 2013

International Orthopaedics (SICOT)

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Background Patients suffering from isolated subacromial impingement (SI) of their shoulder but who are resistant to other therapies benefit substantially from arthroscopic subacromial decompression (ASD) if they are young (<60 years). Although physical demands rise notably in the older population, it still remains unclear if surgery leads to better results in these patients. Therefore, the aim of this study was to focus on the impact of age on the functional outcome in elderly patients suffering from SI. Methods In this retrospective analysis, 307 patients (age range: 42-63 years) with isolated SI were enrolled. The 165 patients were allocated to physical therapy whereas 142 underwent ASD. The patient cohort was divided into two groups according to the median age (<57 years). Functional outcome was recorded using the Munich Shoulder Questionnaire (MSQ) allowing for qualitative self -assessment of the Constant, SPADI and Dark Scores. Results Median age was 57 (25 %-75 %: 48-63) years, follow-up was 55 (25 %-75 %: 25-87) months. In group I (age<57 years, n=165) no significant differences in outcome between physical therapy and ASD were detected. In contrast, in group II (age>57 years; n=142) the patients reported significantly better results after ASD in the overall MSQs. Conclusion Despite their higher age, elderly patients with isolated SI actually benefit significantly from ASD in comparison to physical therapy.

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Conservative or surgical treatment for subacromial impingement syndrome? A systematic review

Cited by 166 publications

References 42 publications

Which patients do not recover from shoulder impingement syndrome, either with operative treatment or with nonoperative treatment?

Which patients do not recover from shoulder impingement syndrome, either with operative treatment or with nonoperative treatment?

The initial effects of a sustained glenohumeral postero-lateral glide during elevation on shoulder muscle activity: A repeated measures study on asymptomatic shoulders

Significant benefit for older patients after arthroscopic subacromial decompression: a long-term follow-up study

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