Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline

@article{Vandvik2019SubacromialDS,
  title={Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline},
  author={Per Olav Vandvik and Tuomas L{\"a}hdeoja and Clare L. Ardern and Rachelle Buchbinder and Jaydeep K. Moro and Jens Ivar Brox and Jako Burgers and Qiukui Hao and Teemu Karjalainen and Michel P J van den Bekerom and Julia C. A. Noorduyn and Lyubov Lytvyn and Reed Alexander Siemieniuk and Alexandra Albin and Sean Chua Shunjie and Florian Fisch and Laurie Proulx and Gordon H. Guyatt and Thomas Agoritsas and Rudolf W Poolman},
  journal={BMJ},
  year={2019},
  volume={364}
}
Abstract Clinical question Do adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery. Current practice SAPS is the common diagnosis for shoulder pain with several first line treatment options, including analgesia, exercises, and injections. Surgeons frequently perform arthroscopic… 

Indications for Arthroscopic Subacromial Decompression. A Level V Evidence Clinical Guideline.

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  • 2019

Subacromial decompression surgery for rotator cuff disease.

Compared with placebo, high-certainty evidence indicates that subacromial decompression provides no improvement in pain, shoulder function, or health-related quality of life up to one year, and probablyNo improvement in global success (moderate-certainity evidence, downgraded due to imprecision).

Editorial Commentary: Arthroscopic Treatment Should No Longer Be Offered to People With Subacromial Impingement.

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  • 2022

Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: a 5-year follow-up of a randomised, placebo surgery controlled clinical trial

ASD provided no benefit over diagnostic arthroscopy (or exercise therapy) at 5 years for patients with shoulder impingement syndrome, and was not compared with a non-operative alternative, exercise therapy.

Return to work after subacromial decompression, diagnostic arthroscopy, or exercise therapy for shoulder impingement: a randomised, placebo-surgery controlled FIMPACT clinical trial with five-year follow-up

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Non-surgical and surgical treatments for rotator cuff disease: a pragmatic randomised clinical trial with 2-year follow-up after initial rehabilitation

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Evidence first, practice second in arthroscopic surgery: use of placebo surgery in randomised controlled trial

This article introduces two procedures (arthroscopic partial menisectomy for degenerative knees and arthroscopic subacromial decompression for subACromial pain syndrome), where over 30 years of procedure usage has continued prior to garnering evidence for the inefficacy of the procedures.

Resident Case Series: Blood Flow Restriction as an Adjunct to Strengthening Exercises in Two Patients with Subacromial Impingement and High Irritability

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Effectiveness of Adding a Large Dose of Shoulder Strengthening to Current Nonoperative Care for Subacromial Impingement: A Pragmatic, Double-Blind Randomized Controlled Trial (SExSI Trial)

Adding a large dose of shoulder strengthening to current nonoperative care for patients with subacromial impingement did not result in superior shoulder-specific patient-reported outcomes, and it was showed that adding more exercise is not a viable solution to this problem.

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A working group formed from a number of Dutch specialist societies, joined by the Dutch Orthopedic Association, has produced a new outlook for the treatment of subacromial pain syndrome, with no convincing evidence that surgical treatment for SAPS is more effective than conservature management.

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Compared with placebo, high-certainty evidence indicates that subacromial decompression provides no improvement in pain, shoulder function, or health-related quality of life up to one year, and probablyNo improvement in global success (moderate-certainity evidence, downgraded due to imprecision).

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Subacromial injections of corticosteroids are effective for improvement for rotator cuff tendonitis up to a 9-month period and are probably more effective than NSAID medication.