Does arthroscopic acromioplasty provide any additional value in the treatment of shoulder impingement syndrome? A TWO-YEAR RANDOMISED CONTROLLED TRIAL
Does arthroscopic acromioplasty provide any additional value in the treatment of shoulder impingement syndrome? A TWO-YEAR RANDOMISED CONTROLLED TRIAL
复制标题
DOI：
10.1302/0301-620x.91b10.22094
复制
发表时间：
2009-10-01
影响因子：
--
通讯作者：
Rousi, T.
中科院分区：
文献类型：
--
作者：
Ketola, S.;Lehtinen, J.;Rousi, T.
我们报告了一项随机对照试验，以检查关节镜肩峰成形术治疗II期肩关节撞击综合征的有效性和成本效益。共140例患者被随机分为两个治疗组：监督锻炼计划（n = 70，锻炼组）和关节镜肩峰成形术后类似的锻炼计划（n = 70，联合治疗组）。主要的结果测量是在24个月时，在视觉模拟量表0到10分的范围内，对134名患者（运动组66名，联合治疗组68名）进行了测量，这些患者的终点数据是可用的。联合治疗是相当昂贵的。关节镜肩峰成形术提供了一个结构化的和监督的锻炼计划单独在主观结果或成本效益方面，在24个月时测量没有临床重要的影响。结构化的运动治疗应该是治疗肩撞击综合征的基础，在其真正的优点被证明之前，应明智地提供手术治疗。
We report a randomised controlled trial to examine the effectiveness and cost-effectiveness of arthroscopic acromioplasty in the treatment of stage II shoulder impingement syndrome. A total of 140 patients were randomly divided into two treatment groups: supervised exercise programme (n = 70, exercise group) and arthroscopic acromioplasty followed by a similar exercise programme (n = 70, combined treatment group). The main outcome measure was self-reported pain on a visual analogue scale of 0 to 10 at 24 months, measured on the 134 patients (66 in the exercise group and 68 in the combined treatment group) for whom endpoint data were available.An intention-to-treat analysis disclosed an improvement in both groups but without statistically significant difference in outcome between the groups (p = 0.65). The combined treatment was considerably more costly.Arthroscopic acromioplasty provides no clinically important effects over a structured and supervised exercise programme alone in terms of subjective outcome or cost-effectiveness when measured at 24 months. Structured exercise treatment should be the basis for treatment of shoulder impingement syndrome, with operative treatment offered judiciously until its true merit is proven.