OBJECTIVE: This prospective investigation is designed to determine the prognostic factors associated with the response to conservative therapy of subacromial impingement syndrome. MATERIALS AND METHODS: We treated 102 patients with subacromial impingement syndrome, diagnosed by physical examination and a subacromial lidocaine injection test, with a standardized conservative protocol. We followed the patients for a period of 12 months. Outcome was evaluated with Constant score and effects of 8 variables: Age, sex, pretreatment symptom duration, dominant shoulder, initial Constant score, active range of motion, acromion morphology, and acromial spur on patient outcomes were evaluated with univariate and multivariate analyses. RESULTS: Among 89 patients (44 men; mean age, 56.4 years) who finished the study, the mean difference between initial and final scores was 15.9 (95% confidence interval [CI]: 13.9-17.8). Three variables, the initial Constant score (b = .52, 95% CI: .28-.76), the duration of disease before treatment (b = -4.4, 95% CI: from -7.2 to -1.6), and acromial morphology (b = -5.3, 95% CI: from -9.8 to -.8) were found to be independent predictors of outcome (model R2 = .68). CONCLUSION: Patients with more severe disease, a long duration of symptoms, and type II or III acromion may require more invasive therapeutic options as the first intervention.
OBJECTIVE: This prospective investigation is designed to determine the prognostic factors associated with the response to conservative therapy of subacromial impingement syndrome. MATERIALS AND METHODS: We treated 102 patients with subacromial impingement syndrome, diagnosed by physical examination and a subacromial lidocaine injection test, with a standardized conservative protocol. We followed the patients for a period of 12 months. Outcome was evaluated with Constant score and effects of 8 variables: Age, sex, pretreatment symptom duration, dominant shoulder, initial Constant score, active range of motion, acromion morphology, and acromial spur on patient outcomes were evaluated with univariate and multivariate analyses. RESULTS: Among 89 patients (44 men; mean age, 56.4 years) who finished the study, the mean difference between initial and final scores was 15.9 (95% confidence interval [CI]: 13.9-17.8). Three variables, the initial Constant score (b = .52, 95% CI: .28-.76), the duration of disease before treatment (b = -4.4, 95% CI: from -7.2 to -1.6), and acromial morphology (b = -5.3, 95% CI: from -9.8 to -.8) were found to be independent predictors of outcome (model R2 = .68). CONCLUSION:Patients with more severe disease, a long duration of symptoms, and type II or III acromion may require more invasive therapeutic options as the first intervention.
Authors: Keith M Baumgarten; James L Carey; Joseph A Abboud; Grant L Jones; John E Kuhn; Brian R Wolf; Robert H Brophy; Charles L Cox; Rick W Wright; Armando F Vidal; C Benjamin Ma; Eric C McCarty; G Brian Holloway; Edwin E Spencer; Warren R Dunn Journal: HSS J Date: 2011-07-13
Authors: Ole M Ekeberg; Erik Bautz-Holter; Niels G Juel; Kaia Engebretsen; Synnøve Kvalheim; Jens I Brox Journal: BMC Musculoskelet Disord Date: 2010-10-15 Impact factor: 2.362
Authors: Ron Diercks; Carel Bron; Oscar Dorrestijn; Carel Meskers; René Naber; Tjerk de Ruiter; Jaap Willems; Jan Winters; Henk Jan van der Woude Journal: Acta Orthop Date: 2014-05-21 Impact factor: 3.717