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

Abstract

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.

Subacromial impingement syndrome: management challenges

“…These outcomes are in line with other study results which, however, are not coming from randomized trial and have shorter follow-up 40,42. Considering the long-term effect of surgical decompression, also for patients >60 years of age,34 authors considered the possibility of long-term protective effect of subacromial decompression in SAIS patients 40,43. Even if there were no statistically significant differences, Farfaras et al34 reported a higher incidence of rotator cuff tears at the follow-up (ultrasound) in the group treated with physical therapy compared with the surgical groups (open acromioplasty: 1; ASD: 1; physiotherapy: 4).…”

Clinical and radiological outcome following treatment of displaced lateral clavicle fractures using a locking compression plate with lateral extension: a prospective study

“…The MSQ is a self-administrated and valid questionnaire to assess different aspects of the shoulder function. It allows for a qualitative self-assessment of the SPADI, the DASH score and the Constant Score [ 12 , 13 ]. In the presented study good to excellent functional results at a mean follow-up of one year after surgery were found.…”

“…It was developed for an effective follow-up of shoulder patients allowing for a quantitative assessment of the Shoulder Pain and Disability Index (SPADI), the Disability of the Arm, Shoulder and Hand (DASH) score and the Constant Score. The MSQ has been validated previously and its accuracy and effectiveness for follow-up assessment was demonstrated [ 12 , 13 ]. Original Constant Score values were used to calculate a normative age- and sex-specific Constant Score (relative Constant Score) according to Gerber et al [ 14 ].…”

Additional calcar support using a blade device reduces secondary varus displacement following reconstruction of the proximal humerus: a prospective study

“…Furthermore clinical examination not necessarily correlates with subjective impression of the patients in terms of satisfaction. In the presented study, follow-up examination was performed by a self-evaluation questionnaire, the Munich Shoulder Questionnaire, allowing for a qualitative self-assessment of the SPADI, the DASH score and the Constant Score [ 17 , 18 ]. Good to excellent functional results at a mean follow-up of 1 year after surgery were found, comparable to other authors who used a locking plate for surgical treatment of proximal humeral fractures [ 22 , 29 ].…”