Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: randomised, placebo surgery controlled clinical trial

BMJ : British Medical Journal
Mika PaavolaFinnish Subacromial Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators

Abstract

To assess the efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy, a placebo surgical intervention, and with a non-operative alternative, exercise therapy, in a more pragmatic setting. Multicentre, three group, randomised, double blind, sham controlled trial. Orthopaedic departments at three public hospitals in Finland. 210 patients with symptoms consistent with shoulder impingement syndrome, enrolled from 1 February 2005 with two year follow-up completed by 25 June 2015. ASD, diagnostic arthroscopy (placebo control), and exercise therapy. Shoulder pain at rest and on arm activity (visual analogue scale (VAS) from 0 to 100, with 0 denoting no pain), at 24 months. The threshold for minimal clinically important difference was set at 15. In the primary intention to treat analysis (ASD versus diagnostic arthroscopy), no clinically relevant between group differences were seen in the two primary outcomes at 24 months (mean change for ASD 36.0 at rest and 55.4 on activity; for diagnostic arthroscopy 31.4 at rest and 47.5 on activity). The observed mean difference between groups (ASD minus diagnostic arthroscopy) in pain VAS were -4.6 (95% confidence interval -11.3 to 2.1) points (P=0.18...Continue Reading

Associated Clinical Trials

Citations

Nov 27, 2018·Acta Orthopaedica·Jonas Ranstam
Jan 3, 2019·The Bone & Joint Journal·F S HaddadT D Tennent
Feb 8, 2019·BMJ : British Medical Journal·Per Olav VandvikRudolf W Poolman
May 17, 2019·Clinical Orthopaedics and Related Research·David Ring, Seth S Leopold
Sep 10, 2019·JAMA Internal Medicine·Daniel J MorganDeborah Korenstein
Jan 2, 2020·The Journal of Orthopaedic and Sports Physical Therapy·Jeremy S LewisPeter O'Sullivan
Apr 14, 2020·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Sean P RileyRiekie de Vet
Dec 7, 2018·British Journal of Sports Medicine·Daniel J Friedman, Karim M Khan
Jan 17, 2019·British Journal of Sports Medicine·Tuomas LähdeojaClare L Ardern
Apr 7, 2020·The Journal of Bone and Joint Surgery. American Volume·David Ring
May 31, 2019·Disability and Rehabilitation·Mikhail SaltychevKatri Laimi
Feb 28, 2020·JBJS Reviews·Luciano A Rossi, Maximiliano Ranalletta
Feb 2, 2019·The Cochrane Database of Systematic Reviews·Teemu V KarjalainenRachelle Buchbinder
Feb 25, 2019·Acta neurochirurgica·Ole Solheim
Aug 1, 2019·Operative Orthopädie und Traumatologie·Kilian RuecklPiet Plumhoff
Mar 3, 2020·The Bone & Joint Journal·Paul J JenkinsAndrew J Brooksbank
Aug 15, 2019·Diagnostic and Prognostic Research·Danielle A van der WindtRichard D Riley
Dec 29, 2019·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Erik HohmannAndreas Imhoff
Dec 8, 2020·Journal of Physical Therapy Science·Amy W McDevittSuzanne Snodgrass
Oct 7, 2020·British Journal of Sports Medicine·Mika PaavolaUNKNOWN Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators
Jan 9, 2021·Nature Reviews. Disease Primers·Neal L MillarScott A Rodeo
Mar 9, 2021·JSES International·Hamez GacaferiCornelis P J Visser
Jul 28, 2020·Journal of Shoulder and Elbow Surgery·Pierre LaumoneriePierre Mansat
Dec 23, 2020·Annals of Surgery·Samantha BunzliMichelle M Dowsey
May 13, 2021·Clinical Orthopaedics and Related Research·Seth S Leopold
May 25, 2021·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Sean P RileyKenneth E Learman
Jul 9, 2021·BMJ : British Medical Journal·Ashley W BlomSetor K Kunutsor
Aug 26, 2021·Acta Orthopaedica·Ian Harris

❮ Previous
Next ❯

Methods Mentioned

BETA
joint
lavage

Software Mentioned

Stata

Related Concepts

Related Feeds

Autism

Autism spectrum disorder is associated with challenges with social skills, repetitive behaviors, and often accompanied by sensory sensitivities and medical issues. Here is the latest research on autism.