Es5 Does Arthroscopic Acromioplasty Provide Any Additional Value in the Treatment of Shoulder Impingement Syndrome? Atwo-Year Randomized Controlled Trial

Ketola, Saara; Lehtinen, Janne; Arnala, I; Nissinen, Markku; Westenius, H.; Aronen, Pasi; Sintonen, Harri; Konttinen, Y T; Malmivaara, A; Rousi, T

doi:10.1016/s1098-3015(10)64904-2

Cited by 13 publications

(25 citation statements)

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“…30,44,46 At the same time, recent studies have highlighted the continuing debate around the role of acromioplasty. 4,17,22,31,36,44 Our findings support repair with minimal acromioplasty rather than formal acromioplasty for bursal-side tears. In addition, we had more ''satisfied'' patients than ''very satisfied'' patients (17 vs 14).…”

Section: Discussionsupporting

confidence: 55%

Clinical and Magnetic Resonance Imaging Results of Arthroscopic Full-Layer Repair of Bursal-Side Partial-Thickness Rotator Cuff Tears

et al. 2011

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Section: Discussionsupporting

confidence: 55%

Clinical and Magnetic Resonance Imaging Results of Arthroscopic Full-Layer Repair of Bursal-Side Partial-Thickness Rotator Cuff Tears

et al. 2011

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“…For example, in a similar retrospective study of 105 patients, Klintberg et al obtained an 88% success rate but specified that only half the patients were completely free of pain [4]. Using pain as the primary outcome measure, Ketola et al found no significant difference after 2 years between patients treated with arthroscopic acromioplasty and those treated medically [8], thus challenging the effectiveness of acromioplasty.…”

Section: Discussionmentioning

confidence: 99%

Failed subacromial decompression. Risk factors

Bouchard

Garret

Favard

et al. 2014

Orthopaedics & Traumatology: Surgery & Research

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“…The number of procedures has increased from 30 per 100 000 people (5571 operations) to 102 per 100 000 (19 743 operations). 15 Ketola et al 16 reported that the average cost of an acromioplasty and postsurgical rehabilitation in Finland was J2961 (equivalent to GB£2479, US$4017). In London, UK, an average price for a series of quotations for private subacromial decompression was GB£3500.…”

Section: Introductionmentioning

confidence: 99%

“…These figures are not definitive and costs in some centres may be less and in others higher. Nonetheless this is of substantial economic burden and healthcare concern, as Ketola et al 16 have stated:…”

Section: Introductionmentioning

confidence: 99%

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Subacromial impingement syndrome: a musculoskeletal condition or a clinical illusion?

Lewis

2011

Physical Therapy Reviews

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Background: Subacromial impingement syndrome is considered by many to be the most common of the musculoskeletal conditions affecting the shoulder. It is based on a hypothesis that acromial irritation leads to external abrasion of the bursa and rotator cuff. Objectives: The aim of this paper is to review the evidence for the acromial irritation theory and in doing so challenge the rationale for subacromial decompression. Major findings: There is a body of evidence that suggests there is a lack of concordance regarding (i) the area of tendon pathology and acromial irritation, (ii) the shape of the acromion and symptoms, (iii) the proposal that irritation leads to the development of tendinitis and bursitis, and (iv) imaging changes and symptoms and the development of the condition. In addition, there is no certainty that the benefit derived from the surgery is due to the removal of the acromion as research suggests that a bursectomy in isolation may confer equivalent benefit. It is also possible that the benefit of surgery is due to placebo or simply enforces a sustained period of relative rest which may allow the involved tissues to achieve relative homeostasis. It is possible that pathology originates in the tendon and as such surgery does not address the primary pathoaetiology. This view is strengthened by the findings of studies that have demonstrated no increased clinical benefit from surgery when compared with exercise. Additionally, exercise therapy is associated with a substantially reduced economic burden and less sick leave. Conclusion: As there is little evidence for an acromial impingement model, a more appropriate name may be 'subacromial pain syndrome'. Moreover, surgery should only be considered after an appropriate period of appropriately structured rehabilitation.

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Es5 Does Arthroscopic Acromioplasty Provide Any Additional Value in the Treatment of Shoulder Impingement Syndrome? Atwo-Year Randomized Controlled Trial

Cited by 13 publications

References 0 publications

Clinical and Magnetic Resonance Imaging Results of Arthroscopic Full-Layer Repair of Bursal-Side Partial-Thickness Rotator Cuff Tears

Clinical and Magnetic Resonance Imaging Results of Arthroscopic Full-Layer Repair of Bursal-Side Partial-Thickness Rotator Cuff Tears

Failed subacromial decompression. Risk factors

Subacromial impingement syndrome: a musculoskeletal condition or a clinical illusion?

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