Significant benefit for older patients after arthroscopic subacromial decompression: a long-term follow-up study
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ORIGINAL PAPER
Significant benefit for older patients after arthroscopic subacromial decompression: a long-term follow-up study Peter Biberthaler & Marc Beirer & Sonja Kirchhoff & Volker Braunstein & Ernst Wiedemann & Chlodwig Kirchhoff
Received: 25 October 2012 / Accepted: 14 December 2012 / Published online: 16 January 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract Background 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 (70 years is not an isolated SIS, but degenerative RCT. In this context, the dropout of >70 % of patients after following the exclusion criteria was mainly caused by confounding RCTs. Though, 142 patients >57 years with isolated SIS have still been included. Reviewing the further inclusion criteria, several authors emphasised the impact of duration of symptoms on the outcome [21, 22]. In this context, Patel et al., have analysed some of the factors possibly influencing the results of ASD and pointed out that besides the response to the impingement test, especially the duration of symptoms of over one year is correlated to a significantly worse outcome. Further criteria such as occupation or insurance status, that were not considered in our study, have been previously shown to be of inferior relevance [16]. Conservative treatment Patients having been treated conservatively received a standard physiotherapy for 12 weeks on an outpatient basis. The protocol with focus on strengthening of the rotator cuff and the scapular stabilising muscles is comparable to previous studies. Although patients thereby did not undergo formal training by physiotherapists, we regard this to be not statistically significant. In this context, Andersen et al., in 1999 analysed the effectiveness and outcome following a physiotherapeutically supervised vs. an unsupervised self-training following ASD and demonstrated clearly significant poorer results in the supervised group [23].
Fig. 2 Outcome results of patients older than 57 years (group II). Light grey: conservative treatment; dark grey: Arthroscopic subacromial decompression (ASD) Data are given as vertical boxplots (median: horizontal boxline; 25–75 % interquartile ranges; standard deviations: horizontal line). * p
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