PT  - JOURNAL ARTICLE
AU  - J P Haahr
AU  - S Østergaard
AU  - J Dalsgaard
AU  - K Norup
AU  - P Frost
AU  - S Lausen
AU  - E A Holm
AU  - J H Andersen
TI  - Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up
AID  - 10.1136/ard.2004.021188
DP  - 2005 May 01
TA  - Annals of the Rheumatic Diseases
PG  - 760--764
VI  - 64
IP  - 5
4099  - http://ard.bmj.com/content/64/5/760.short
4100  - http://ard.bmj.com/content/64/5/760.full
SO  - Ann Rheum Dis2005 May 01; 64
AB  - Objectives: To compare the effect of graded physiotherapeutic training of the rotator cuff versus arthroscopic subacromial decompression in patients with subacromial impingement. Methods: Randomised controlled trial with 12 months’ follow up in a hospital setting. Ninety consecutive patients aged 18 to 55 years were enrolled. Symptom duration was between six months and three years. All fulfilled a set of diagnostic criteria for rotator cuff disease, including a positive impingement sign. Patients were randomised either to arthroscopic subacromial decompression, or to physiotherapy with exercises aiming at strengthening the stabilisers and decompressors of the shoulder. Outcome was shoulder function as measured by the Constant score and a pain and dysfunction score. “Intention to treat” analysis was used, with comparison of means and control of confounding variables by general equation estimation analysis. Results: Of 90 patients enrolled, 84 completed follow up (41 in the surgery group, 43 in the training group). The mean Constant score at baseline was 34.8 in the training group and 33.7 in the surgery group. After 12 months the mean scores improved to 57.0 and 52.7, respectively, the difference being non-significant. No group differences in mean pain and dysfunction score improvement were found. Conclusions: Surgical treatment of rotator cuff syndrome with subacromial impingement was not superior to physiotherapy with training. Further studies are needed to qualify treatment choice decisions, and it is recommended that samples are stratified according to disability level.