Proper Indications for Shoulder Subacromial Decompression Result in Excellent Outcomes

Consensus Statement for Shoulder Impingement: To Operate or Not? Who to Ask for the Consensus Panel

“…The fact that the authors of the statement apparently believe that personal experience and excellence prevail over the existing evidence is worrisome. 13,17,19 We argue that this expert consensus statement only expresses the opinion of a selected group of surgeons and therefore is not generalizable. The statement emphasizes the fact that surgeons may have strong habits and that implementation of the available evidence takes a lot of time, effort, and behavioral change.…”

“…reviewed the selected hits (15 publications from 11 panel members) for relevance. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] To gain insight into the possible preferences for surgical approach, all publications of the panel members on the shoulder impingement subject, without time restriction, were also scored for this outcome. In cases of disagreement, assessment by a third reviewer (E.J.D.V.)…”

“…was decisive. Seven articles were considered relevant 7,[13][14][15]17,19,20 (and 8 were not [8][9][10][11][12]16,18,21 ). Of all articles related to shoulder impingement, 10 were scored as "in favor of surgery" [10][11][12][13][14][15][16][17]19,20 ; none, "not in favor of surgery"; and 5, "inconclusive."…”

“…Seven articles were considered relevant 7,[13][14][15]17,19,20 (and 8 were not [8][9][10][11][12]16,18,21 ). Of all articles related to shoulder impingement, 10 were scored as "in favor of surgery" [10][11][12][13][14][15][16][17]19,20 ; none, "not in favor of surgery"; and 5, "inconclusive." [7][8][9]18,21 In contrast, of the 90 authors of systematic reviews (or studies included in these reviews) referred to in the consensus article, just 1 (G.A.)…”

Subacromial Decompression in Patients With Shoulder Impingement With an Intact Rotator Cuff: An Expert Consensus Statement Using the Modified Delphi Technique Comparing North American to European Shoulder Surgeons

“…3 However, the procedure remains highly controversial, and there is considerable discussion as to whether SAD should still be performed. [9][10][11][12][13] Continuation of this practice has been discouraged by 3 recent meta-analyses, [14][15][16] which concluded that surgical intervention has little benefit, with only small improvements regarding pain and function. However, these authors also admitted that the evidence is of low and moderate quality with moderateto-high risk of bias and noted that further research is required to identify patients who will reliably benefit from surgical intervention.…”