Year: 2018  Study type: RCT  

Paavola M, Malmivaara A, Taimela S, Kanto K, Inkinen J, Kalske J et al. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: randomised, placebo surgery controlled clinical trial. BMJ 2018;19(362):k2860.

Objective

To evaluate the efficacy of arthroscopic subacromial decompression (ASD) in patients with shoulder symptoms consistent with shoulder impingement syndrome.

Methods

210 patients with symptoms consistent with shoulder impingement syndrome were randomized into two groups; surgery or exercise therapy (ratio 2:1). Surgery group patients were further randomized into ASD or diagnostic arthroscopy (ratio 1:1). Only patients with a partial tear that did not need repair (grade I and II) were included for the study.

Main outcome: Shoulder pain at rest and on arm activity (VAS) at 2-year follow-up. 

Outcome

Arthroscopic subacromial decompression did not provide any benefits over diagnostic arthroscopy at 2-year follow up. The findings do not support the current practice of performing ASD in patients with shoulder impingement syndrome.