Abstract
Abstract Background The benefits of the various therapeutic options for the treatment of subacromial impingement syndrome are a topic of ongoing debate. Several studies on the subject are insufficiently evidence-based, with many other studies being considered controversial by members of the field. Nevertheless, a general opinion against surgical interventions is developing in the media in reference to these systematic reviews and meta-analyses based on insufficiently differentiated literature. Aim of the study This article provides an overview of the literature and examines the outcome after arthroscopic subacromial decompression compared with conservative therapy or diagnostic arthroscopy and bursectomy. Conclusion The outcome for patients treated with conservative therapy or subacromial decompression who explicitly suffered from mechanical outlet impingement (MOI) or mechanical non-outlet impingement (MNOI) has not yet been studied. The main problem concerning almost all published studies is that they are based on a mixture of pathologies. It seems likely that especially patients with a mechanical, and therefore structural, narrowing of the subacromial space can profit more from surgical management than patients with unspecific subacromial pain. Differentiation between the pathologies is crucial for the correct treatment decision, not only for the reduction of symptoms, but most importantly for the preservation of the supraspinatus tendon.
Highlights
The relative benefits of the various therapeutic options for the treatment of impingement syndrome of the shoulder joint are a topic of ongoing debate
This definition was initially published in Dutch guidelines for the diagnosis and therapy of subacromial pain syndrome (SAPS) and summarizes atraumatic, mostly unilateral pathologies that lead to shoulder pain that increases during abduction of the joint
This article provides an overview of the literature and examines the outcome after arthroscopic subacromial decompression compared with conservative therapy or diagnostic arthroscopy and bursectomy
Summary
The relative benefits of the various therapeutic options for the treatment of impingement syndrome of the shoulder joint are a topic of ongoing debate. In order to respect the content of all terminologies, and to refer to possibly different reasons for subacromial impingement, the name subacromial pain syndrome was later introduced [7] This definition was initially published in Dutch guidelines for the diagnosis and therapy of SAPS and summarizes atraumatic, mostly unilateral pathologies that lead to shoulder pain that increases during abduction of the joint. The authors found a positive correlation between the following parameters and a positive outcome after subacromial decompression: pain during overhead activity, duration of pain longer than 6 months, ongoing problems despite continuous physiotherapy, positive Hawkins sign, radiological signs of subacromial impingement (sclerosis and/or osteophytes under the acromion or on the greater tuberosity) and improvement for at least 1 week following subacromial corticoid injection According to these parameters, a maximum of six points can be reached in the PrOS.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
