Skip to main content
SpringerLink
Log in

Long-term patient satisfaction and functional outcome 8–11 years after subacromial decompression

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The aim of this investigation was to evaluate the long-term outcome of arthroscopic subacromial decompression (ASD) in patients with primary impingement syndrome stage II and early stage III. Ninety-five patients (105 shoulders, 48 female), mean age 54 years (range 26–69), who had undergone surgery between 1996 and 1999, were included. Pain intensity during activity and at rest, patient satisfaction, active range of motion (ROM), muscular strength and shoulder function using the Constant score were evaluated. Fifty-three (50%) shoulders were pain-free (Visual Analogue Scale ≤ 10 mm) during activity and 72 (68%) shoulders were pain-free at rest. Sixty-one (58%) patients stated that they were very satisfied and 27 (25%) were quite satisfied with regard to their current shoulder function. Shoulders were divided into Group 1: Pain-free patients (n = 53), Group 2: Patients with shoulder pain and no arthropathy (n = 41) and Group 3: Patients with shoulder pain and arthropathy (n = 11). The groups had average active ROM of 157°, 135° and 117°, respectively, in abduction and 97°, 79°, and 68° in external rotation. The average strength in elevation in the scapular plane was 7.4, 5.8 and 3.9 kg, respectively, whereas the mean value in external rotation was 8.4, 7.9 and 5.3 kg, respectively. The Constant score had a mean value of 87, 69 and 59 points in the three groups, respectively. Eleven shoulders have undergone re-operation, one after a new trauma. We conclude that ASD is a valuable procedure. Patients expressed a high degree of satisfaction with shoulder function 8–11 years after ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Anderson NH, Sojbjerg JO, Johannsen HV, Sneppen O (1999) Self-training versus physiotherapist-supervised rehabilitation of the shoulder in patients treated with arthroscopic subacromial decompression: a clinical randomized study. J Shoulder Elbow Surg 8:99–101

    Article  Google Scholar 

  2. Bengtsson M, Lunsjo K, Hermodsson Y et al (2006) High patient satisfaction after arthroscopic subacromial decompression for shoulder impingement: a prospective study of 50 patients. Acta Orthop 77:138–142

    Article  PubMed  Google Scholar 

  3. Boone DC, Azen SP, Lin CM et al (1978) Reliability of goniometric measurements. Phys Ther 58:1355–1390

    CAS  PubMed  Google Scholar 

  4. Brewster C, Schwab DR (1993) Rehabilitation of the shoulder following rotator cuff injury or surgery. J Orthop Sports Phys Ther 18:422–426

    CAS  PubMed  Google Scholar 

  5. Brox JI, Gjengedal E, Uppheim G et al (1999) Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): a prospective, randomized, controlled study in 125 patients with a 2 1/2-year follow-up. J Shoulder Elbow Surg 8:102–111

    Article  CAS  PubMed  Google Scholar 

  6. Budoff JE, Nirschl RP, Guidi EJ (1998) Debridement of partial-thickness tears of the rotator cuff without acromioplasty. Long-term follow-up and review of the literature. J Bone Joint Surg Am 80:733–748

    CAS  PubMed  Google Scholar 

  7. Böhmer AS, Staff PH, Brox JI (1998) Supervised exercises in relation to rotator cuff disease (impingement syndrome stages II and III): a treatment regimen and its rationale. Physiother Theory Pract 14:93–105

    Article  Google Scholar 

  8. Chipchase LS, O’Connor DA, Costi JJ, Krishnan J (2000) Shoulder impingement syndrome: preoperative health status. J Shoulder Elbow Surg 9:12–15

    Article  CAS  PubMed  Google Scholar 

  9. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  10. Croft PR, Macfarlane GJ, Papageorgiou AC et al (1998) Outcome of low back pain in general practice: a prospective study. BMJ 316:1356–1359

    CAS  PubMed  Google Scholar 

  11. Dom K, Van Glabbeek F, Van Riet RP et al (2003) Arthroscopic subacromial decompression for advanced (stage II) impingement syndrome: a study of 52 patients with five years follow-up. Acta Orthop Belg 69:13–17

    CAS  PubMed  Google Scholar 

  12. Edelson G, Teitz C (2000) Internal impingement in the shoulder. J Shoulder Elbow Surg 9:308–315

    Article  CAS  PubMed  Google Scholar 

  13. Gajdosik RL, Bohannon RW (1987) Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther 67:1867–1872

    CAS  PubMed  Google Scholar 

  14. Haahr JP, Ostergaard S, Dalsgaard J et al (2005) Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Ann Rheum Dis 64:760–764

    Article  CAS  PubMed  Google Scholar 

  15. Harryman DT, Sidles JA, Clark JM et al (1990) Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am 72:1334–1343

    PubMed  Google Scholar 

  16. Hartsell HD, Forwell L (1997) Postoperative eccentric and concentric isokinetic strength for the shoulder rotators in the scapular and neutral planes. J Orthop Sports Phys Ther 25:19–25

    CAS  PubMed  Google Scholar 

  17. Herberts P, Kadefors R, Andersson G, Petersen I (1981) Shoulder pain in industry: an epidemiological study on welders. Acta Orthop Scand 52:299–306

    CAS  PubMed  Google Scholar 

  18. Jackins S (2004) Postoperative shoulder rehabilitation. Phys Med Rehabil Clin N Am 15:643–682

    Google Scholar 

  19. Jobe FW, Jobe CM (1983) Painful athletic injuries of the shoulder. Clin Orthop Relat Res 291:117–124

    Google Scholar 

  20. Jobe FW, Kvitne RS, Giangarra CE (1989) Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement. Orthop Rev 18:963–975

    CAS  PubMed  Google Scholar 

  21. Järvholm U, Palmerud G, Herberts P et al (1989) Intramuscular pressure and electromyography in the supraspinatus muscle at shoulder abduction. Clin Orthop Relat Res 245:102–109

    PubMed  Google Scholar 

  22. Kamkar A, Irrgang JJ, Whitney SL (1993) Nonoperative management of secondary shoulder impingement syndrome. J Orthop Sports Phys Ther 17:212–224

    CAS  PubMed  Google Scholar 

  23. Katolik LI, Romeo AA, Cole BJ et al (2005) Normalization of the Constant score. J Shoulder Elbow Surg 14:279–285

    Article  PubMed  Google Scholar 

  24. Kibler WB (1998) The role of the scapula in athletic shoulder function. Am J Sports Med 26:325–337

    CAS  PubMed  Google Scholar 

  25. Leggin BG, Neuman RM, Iannotti JP et al (1996) Intrarater and interrater reliability of three isometric dynamometers in assessing shoulder strength. J Shoulder Elbow Surg 5:18–24

    Article  CAS  PubMed  Google Scholar 

  26. Lewis JS, Wright C, Green A (2005) Subacromial impingement syndrome: the effect of changing posture on shoulder range of movement. J Orthop Sports Phys Ther 35:72–87

    PubMed  Google Scholar 

  27. Linsell L, Dawson J, Zondervan K et al (2006) Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral. Rheumatology (Oxford) 45:215–221

    Article  CAS  Google Scholar 

  28. Lippitt S, Matsen F (1993) Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res 291:20–28

    PubMed  Google Scholar 

  29. McCormack HM, Horne DJ, Sheather S (1988) Clinical applications of visual analogue scales: a critical review. Psychol Med 18:1007–1019

    Article  CAS  PubMed  Google Scholar 

  30. McIntosh L, McKenna K, Gustafsson L (2003) Active and passive shoulder range of motion in healthy older people. Br J Occup Ther 66:318–324

    Google Scholar 

  31. Meldrum D, Cahalane E, Conroy R et al (2007) Maximum voluntary isometric contraction: reference values and clinical application. Amyotroph Lateral Scler 8:47–55

    Article  PubMed  Google Scholar 

  32. Millett PJ, Wilcox RB III, O’Holleran JD, Warner JJ (2006) Rehabilitation of the rotator cuff: an evaluation-based approach. J Am Acad Orthop Surg 14:599–609

    PubMed  Google Scholar 

  33. Neer CS II (1983) Impingement lesions. Clin Orthop Relat Res 54:70–77

    Google Scholar 

  34. Norlin R, Adolfsson L (2008) Small full-thickness tears do well ten to thirteen years after arthroscopic subacromial decompression. J Shoulder Elbow Surg 17:12S–16S

    Article  PubMed  Google Scholar 

  35. Nygren A, Berglund A, von Koch M (1995) Neck-and-shoulder pain, an increasing problem. Strategies for using insurance material to follow trends. Scand J Rehabil Med Suppl 32:107–112

    CAS  PubMed  Google Scholar 

  36. Odenbring S, Wagner P, Atroshi I (2008) Long-term outcomes of arthroscopic acromioplasty for chronic shoulder impingement syndrome: a prospective cohort study with a minimum of 12 years’ follow-up. Arthroscopy 24:1092–1098

    PubMed  Google Scholar 

  37. Paine RM, Voight M (1993) The role of the scapula. J Orthop Sports Phys Ther 18:386–391

    CAS  PubMed  Google Scholar 

  38. Roddey TS, Cook KF, O’Malley KJ, Gartsman GM (2005) The relationship among strength and mobility measures and self-report outcome scores in persons after rotator cuff repair surgery: impairment measures are not enough. J Shoulder Elbow Surg 14:95S–98S

    Article  PubMed  Google Scholar 

  39. Roye RP, Grana WA, Yates CK (1995) Arthroscopic subacromial decompression: two- to seven-year follow-up. Arthroscopy 11:301–306

    Article  CAS  PubMed  Google Scholar 

  40. Townsend H, Jobe FW, Pink M, Perry J (1991) Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Am J Sports Med 19:264–272

    Article  CAS  PubMed  Google Scholar 

  41. van der Windt DA, Koes BW, de Jong BA, Bouter LM (1995) Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis 54:959–964

    Article  PubMed  Google Scholar 

  42. Wang CH, McClure P, Pratt NE, Nobilini R (1999) Stretching and strengthening exercises: their effect on three-dimensional scapular kinematics. Arch Phys Med Rehabil 80:923–929

    Article  CAS  PubMed  Google Scholar 

  43. Warner JJ, Micheli LJ, Arslanian LE et al (1990) Patterns of flexibility, laxity, and strength in normal shoulders and shoulders with instability and impingement. Am J Sports Med 18:366–375

    Article  CAS  PubMed  Google Scholar 

  44. Warner JJ, Micheli LJ, Arslanian LE et al (1992) Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome. A study using Moire topographic analysis. Clin Orthop Relat Res 18:191–199

    Google Scholar 

  45. Wilk KE, Andrews JR (1993) Rehabilitation following arthroscopic subacromial decompression. Orthopedics 16:349–358

    CAS  PubMed  Google Scholar 

  46. Wilk KE, Arrigo CA, Andrews JR (1991) Standardized isokinetic testing protocol for the throwing shoulder: the throwers’ series. Isokinet Exerc Sci 1:63–71

    Google Scholar 

Download references

Acknowledgements

The authors would like to thank Gun-Brith Åsell, research assistant, for co-ordinating patient visits and administration and Valter Sund for statistical support. Financial support was provided by the Västra Götaland (research and education) research fund and the Centre for Sports Medicine Research. This study was approved by the Human Ethics Committee at the University of Gothenburg.

Author information

Authors and Affiliations

  1. Department of Physiotherapy, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden

    Ingrid Hultenheim Klintberg & Ulla Svantesson

  2. Department of Orthopaedics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Ingrid Hultenheim Klintberg & Jón Karlsson

  3. Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Ingrid Hultenheim Klintberg & Ulla Svantesson

Authors
  1. Ingrid Hultenheim Klintberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ulla Svantesson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jón Karlsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ingrid Hultenheim Klintberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Klintberg, I.H., Svantesson, U. & Karlsson, J. Long-term patient satisfaction and functional outcome 8–11 years after subacromial decompression. Knee Surg Sports Traumatol Arthrosc 18, 394–403 (2010). https://doi.org/10.1007/s00167-009-0963-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-009-0963-1

Keywords

Search

Navigation