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

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.

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.

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.

Despite their higher age, elderly patients with isolated SI actually benefit significantly from ASD in comparison to physical therapy.