Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis

Saltychev, Mikhail; Äärimaa, Ville; Virolainen, Petri; Laimi, Katri

doi:10.3109/09638288.2014.907364

Cited by 89 publications

(68 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Operative treatment is commonly used for shoulder impingement syndrome, even though its effectiveness has not been proven in the literature (Papadonikolakis et al 2011, Diercks et al 2014, Saltychev et al 2015). The fact that the diagnosis is merely clinical also makes comparison of different studies difficult.…”

Section: Discussionmentioning

confidence: 99%

“…The fact that the diagnosis is merely clinical also makes comparison of different studies difficult. 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: Discussionmentioning

confidence: 99%

“…In most studies, the inclusion criterion has simply been failure of nonoperative treatment (Brox et al 1999, Henkus et al 2009). We have already done a cost-effectiveness study that suggested that arthroscopic acromioplasty followed by a structural exercise program is less cost-effective than exercise treatment alone (Ketola et al 2009), and this was confirmed by Saltychev et al (2015). We have now analyzed the 140 impingement patients from our previous study (Ketola et al 2009) in subgroups to find out whether there is a subgroup of patients who would really benefit from arthroscopic acromioplasty.…”

mentioning

confidence: 95%

“…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). However, arthroscopic acromioplasty has been increasingly used during the last decade (Paloneva et al 2015).…”

mentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2015

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 95%

mentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2015

View full text Add to dashboard Cite

show abstract

“…2 Disorders of the rotator cuff, including shoulder impingement syndrome (SIS), are among the most common causes of shoulder pain. 4 Other conditions include those that are unspecified and adhesive capsulitis (AC). 5,6 Primary treatment options considered in usual care typically consist of analgesics or exercises and progress to secondary and tertiary options of steroid injections or surgery if necessary.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

Hawk

Minkalis

Khorsan

et al. 2017

Journal of Manipulative and Physiological Therapeutics

View full text Add to dashboard Cite

Objective: The purpose of this review was to evaluate the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder. Methods: The review was conducted from March 2016 to November 2016 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered with PROSPERO. Eligibility criteria included randomized controlled trials (RCTs), systematic reviews, or meta-analyses studying adult patients with a shoulder diagnosis. Interventions qualified if they did not involve prescription medication or surgical procedures, although these could be used in the comparison group or groups. At least 2 independent reviewers assessed the quality of each study using the Scottish Intercollegiate Guidelines Network checklists. Shoulder conditions addressed were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs), adhesive capsulitis (AC), and nonspecific shoulder pain. Results: Twenty-five systematic reviews and 44 RCTs met inclusion criteria. Low-to moderate-quality evidence supported the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for SIS and AC. For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions. Conclusion: The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for modalities used for common shoulder conditions. (J Manipulative Physiol Ther 2017;40:293-319)

show abstract

Subacromial decompression surgery for rotator cuff disease

Karjalainen

Jain

Page

et al. 2019

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Background Surgery for rotator cuff disease is usually used after non-operative interventions have failed, although our Cochrane Review, first published in 2007, found that there was uncertain clinical benefit following subacromial decompression surgery. Objectives To synthesise the available evidence of the benefits and harms of subacromial decompression surgery compared with placebo, no intervention or non-surgical interventions in people with rotator cuff disease (excluding full thickness rotator cuff tears). Search methods We searched CENTRAL, MEDLINE, Embase, Clinicaltrials.gov and WHO ICRTP registry from 2006 until 22 October 2018, unrestricted by language. Selection criteria We included randomised and quasi-randomised controlled trials (RCTs) of adults with rotator cuff disease (excluding full-thickness tears), that compared subacromial decompression surgery with placebo, no treatment, or any other non-surgical interventions. As it is least prone to bias, subacromial decompression compared with placebo was the primary comparison. Other comparisons were subacromial decompression versus exercises or non-operative treatment. Major outcomes were mean pain scores, shoulder function, quality of life, participant global assessment of success, adverse events and serious adverse events. The primary endpoint for this review was one year. For serious adverse events, we also included data from prospective cohort studies designed to record harms that evaluated subacromial decompression surgery or shoulder arthroscopy.

show abstract

Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis

Cited by 89 publications

References 20 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?

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

Subacromial decompression surgery for rotator cuff disease

Contact Info

Product

Resources

About