Does arthroscopic sub-acromial decompression really work for sub-acromial impingement syndrome: a cohort study

Area of Science:

• Orthopedic Surgery
• Shoulder Arthroscopy
• Musculoskeletal Disorders

Background:

• Sub-Acromial Impingement Syndrome (SAIS) is associated with poor patient outcomes and delayed return to work following Arthroscopic Sub-Acromial Decompression (ASAD).
• Evaluating the effectiveness of ASAD is crucial for justifying its use in clinical practice.

Purpose of the Study:

• To assess the clinical effectiveness of ASAD for SAIS patients.
• To correlate clinical outcomes with the rate of return to work post-ASAD.

Main Methods:

• Prospective cohort study and retrospective data review from the Nottingham Shoulder database.
• Inclusion criteria: SAIS patients who failed conservative treatment and underwent ASAD.
• Pre-operative and 6-month post-operative Oxford Shoulder Score (OSS) and Constant Score (CS) were compared; return to work and hobbies were analyzed.

Main Results:

• Significant improvements observed in OSS (median +15) and CS (median +28) at 6 months post-ASAD (p < 0.0001).
• Statistically significant improvements noted in pain, ADL, ROM, and strength.
• 76% of patients returned to pre-operative work levels (mean 11.5 weeks), and 79% returned to hobbies (mean 11.8 weeks).

Conclusions:

• ASAD leads to significant subjective and objective improvements in SAIS patients with prior failed conservative treatment.
• The study demonstrates a good rate of return to work, contrasting with previously reported outcomes.
• ASAD is an effective treatment for SAIS in patients who have not responded to conservative management.