دورية أكاديمية
Subacromial Decompression Yields a Better Clinical Outcome Than Therapy Alone: A Prospective Randomized Study of Patients With a Minimum 10-Year Follow-up.
| العنوان: | Subacromial Decompression Yields a Better Clinical Outcome Than Therapy Alone: A Prospective Randomized Study of Patients With a Minimum 10-Year Follow-up. |
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| المؤلفون: | Farfaras S; Department of Orthopedics, NU-Hospital Group, Trollhättan/Uddevalla, Sweden.; Sahlgrenska Academy-Gothenburg University, Gothenburg, Sweden., Sernert N; Sahlgrenska Academy-Gothenburg University, Gothenburg, Sweden.; Department of Research and Development, NU-Hospital Group, Trollhättan, Sweden., Rostgard Christensen L; Department of Radiology, Lidköping Hospital, Lidköping, Sweden., Hallström EK; Department of Orthopedics, NU-Hospital Group, Trollhättan/Uddevalla, Sweden.; Sahlgrenska Academy-Gothenburg University, Gothenburg, Sweden., Kartus JT; Department of Orthopedics, NU-Hospital Group, Trollhättan/Uddevalla, Sweden.; Sahlgrenska Academy-Gothenburg University, Gothenburg, Sweden.; Department of Research and Development, NU-Hospital Group, Trollhättan, Sweden. |
| المصدر: | The American journal of sports medicine [Am J Sports Med] 2018 May; Vol. 46 (6), pp. 1397-1407. Date of Electronic Publication: 2018 Mar 15. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 7609541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-3365 (Electronic) Linking ISSN: 03635465 NLM ISO Abbreviation: Am J Sports Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2004- : Thousand Oaks, CA : Sage Publications Original Publication: Baltimore, Williams & Wilkins. |
| مواضيع طبية MeSH: | Arthroplasty* , Arthroscopy* , Decompression, Surgical* , Physical Therapy Modalities*, Shoulder Impingement Syndrome/*surgery, Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteoarthritis/complications ; Osteoarthritis/diagnostic imaging ; Prospective Studies ; Risk Factors ; Rotator Cuff Injuries/complications ; Rotator Cuff Injuries/diagnostic imaging ; Shoulder Impingement Syndrome/complications ; Ultrasonography |
| مستخلص: | Background: The long-term outcome after the treatment of subacromial impingement syndrome (SAIS) with either nonsurgical or surgical methods has not been thoroughly investigated. Hypothesis/Purpose: The purpose was to evaluate the long-term clinical outcome and the presence of rotator cuff injuries and osteoarthritis (OA) after the surgical and nonsurgical treatment of SAIS. The hypothesis was that, at a minimum 10 years after the initial treatment, patients who had undergone acromioplasty would have a better clinical outcome and run a lower risk of developing rotator cuff ruptures and OA as compared with those treated with physical therapy. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Eighty-seven patients with SAIS were randomized to 3 groups: open acromioplasty (open surgery group [OSG]), arthroscopic acromioplasty (arthroscopic surgery group [ASG]), and nonsurgical treatment (physical therapy group [PTG]). The Constant score, the Watson and Sonnabend score, and the 36-Item Short Form Health Survey (SF-36) questionnaire were used as outcome measurements. Furthermore, bilateral ultrasound examinations were performed to detect rotator cuff ruptures and bilateral radiographs to detect OA. Sixty-six patients (76%) attended the clinical follow-up at least 10 years after the initial treatment. Results: The groups were demographically comparable at baseline. The Constant score improved significantly at follow-up for the OSG ( P = .003) and ASG ( P = .011), while no significant improvement was detected for the PTG. The OSG revealed a significant improvement versus the PTG at follow-up ( P = .011); otherwise, no significant differences were found. For the Watson and Sonnabend score, the OSG revealed a significant improvement in 13 of 14 questions. The corresponding finding was made for the ASG and PTG in 9 of 14 questions ( P = .14). According to ultrasound, 1 of 20 patients in the OSG had a full-thickness rotator cuff rupture on the index side. The corresponding finding was made for 1 of 18 patients in the ASG and 4 of 28 in the PTG ( P = .29). Per the radiographs, 3 of 20 patients in the OSG had moderate or severe OA in the index shoulder. The corresponding finding was made for 1 of 18 patients in the ASG and 0 of 28 in the PTG ( P = .12). Conclusion: After a minimum 10 years of follow-up, the surgical treatment of SAIS appears to render better clinical results than physical therapy alone. No significant differences were found among the groups in terms of the presence of full-thickness rotator cuff ruptures and OA. |
| فهرسة مساهمة: | Keywords: long term; osteoarthritis; physical therapy; rotator cuff rupture; subacromial decompression; subacromial impingement |
| تواريخ الأحداث: | Date Created: 20180316 Date Completed: 20190904 Latest Revision: 20190904 |
| رمز التحديث: | 20240513 |
| DOI: | 10.1177/0363546518755759 |
| PMID: | 29543510 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1552-3365 |
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| DOI: | 10.1177/0363546518755759 |