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Significant benefit for older patients after arthroscopic subacromial decompression: a long-term follow-up study

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Abstract

Background

Patients suffering from isolated subacromial impingement (SI) of their shoulder but who are resistant to other therapies benefit substantially from arthroscopic subacromial decompression (ASD) if they are young (<60 years). Although physical demands rise notably in the older population, it still remains unclear if surgery leads to better results in these patients. Therefore, the aim of this study was to focus on the impact of age on the functional outcome in elderly patients suffering from SI.

Methods

In this retrospective analysis, 307 patients (age range: 42–63 years) with isolated SI were enrolled. The 165 patients were allocated to physical therapy whereas 142 underwent ASD. The patient cohort was divided into two groups according to the median age (<57 years). Functional outcome was recorded using the Munich Shoulder Questionnaire (MSQ) allowing for qualitative self -assessment of the Constant, SPADI and Dark Scores.

Results

Median age was 57 (25 %–75 %: 48–63) years, follow-up was 55 (25 %–75 %: 25–87) months. In group I (age < 57 years, n = 165) no significant differences in outcome between physical therapy and ASD were detected. In contrast, in group II (age > 57 years; n = 142) the patients reported significantly better results after ASD in the overall MSQs.

Conclusion

Despite their higher age, elderly patients with isolated SI actually benefit significantly from ASD in comparison to physical therapy.

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Acknowledgments

We thank Florian Schmidutz for his outstanding assistance throughout the pre-study and Wolf Mutschler for having created an excellent cluster with all possibilities to develop and conduct frontier science.

Conflict of interests

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Trauma Surgery, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Muenchen, Germany

    Peter Biberthaler, Marc Beirer & Chlodwig Kirchhoff

  2. Institute of Clinical Radiology-Großhadern, Ludwig-Maximilians-Universitaet Muenchen, Marchioninistrasse 27, 81366, Muenchen, Germany

    Sonja Kirchhoff

  3. Department of Surgery-Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Nussbaumstrasse 20, 80339, Muenchen, Germany

    Volker Braunstein

  4. OCM (Orthopaedic Surgery Munich), Steinerstrasse 6, 81369, Muenchen, Germany

    Ernst Wiedemann

Authors
  1. Peter Biberthaler
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  2. Marc Beirer
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  3. Sonja Kirchhoff
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  4. Volker Braunstein
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  5. Ernst Wiedemann
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  6. Chlodwig Kirchhoff
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Correspondence to Chlodwig Kirchhoff.

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Biberthaler, P., Beirer, M., Kirchhoff, S. et al. Significant benefit for older patients after arthroscopic subacromial decompression: a long-term follow-up study. International Orthopaedics (SICOT) 37, 457–462 (2013). https://doi.org/10.1007/s00264-012-1760-x

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  • DOI: https://doi.org/10.1007/s00264-012-1760-x

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