Zeiad Al-Ani1, Eivind Wergeland Jacobsen2,3, Jüri-Toomas Kartus4, Gunnar Knutsen2, Khaled Meknas5,6. 1. Department of Radiology, University Hospital North Norway, 9038, Tromsö, Norway. 2. Department of Orthopedics, University Hospital North Norway, 9038, Tromsö, Norway. 3. Orthopedics Research Group, Institute of Clinical Medicine, The Arctic University of Norway, 9037, Tromsö, Norway. 4. Department of Orthopedics, NU-Hospital Group, University of Gothenburg, Trollhättan, Sweden. 5. Department of Orthopedics, University Hospital North Norway, 9038, Tromsö, Norway. khaled.meknas@uit.no. 6. Orthopedics Research Group, Institute of Clinical Medicine, The Arctic University of Norway, 9037, Tromsö, Norway. khaled.meknas@uit.no.
Abstract
PURPOSE:Subacromial pain syndrome is a common disorder. Arthroscopic subacromial decompression is currently the preferred treatment method. Bipolar radiofrequency microtenotomy has shown promising results in treating tendinosis. In this study, the authors compare the results after arthroscopic acromioplasty with bipolar radiofrequency microtenotomy for patients with subacromial pain syndrome. METHODS: A total of 27 patients, with subacromial pain syndrome, were followed for 2 years. There were 14 patients in the arthroscopic acromioplasty group and 13 patients in the radiofrequency microtenotomy group. Clinical outcome data included pain reported using a visual analog scale, Constant score, and strength. Magnetic resonance imaging of the affected shoulder was performed before and 2 years after intervention for an evaluation of the tendinosis grade. RESULTS: All patients attended the final follow-up 2 years after intervention. No significant differences were found at baseline between the groups. Pain measured by the visual analog scale revealed a significant reduction in both groups at 12 weeks, 6 months and 2 years compared with baseline. There was no significant difference between the groups in terms of visual analog scale, Constant score, or strength. The magnetic resonance imaging revealed a significant improvement in the tendinosis score in both groups, without any significant difference between the groups. CONCLUSION: In this prospective randomized study, the clinical assessments revealed a significant improvement in terms of the visual analog scale, strength, Constant score, and tendinosis score 2 years after intervention with either arthroscopic acromioplasty or radiofrequency microtenotomy in patients with subacromial pain syndrome. However, no significant differences were found between the groups. This study reveals that there are surgical options other than acromioplasty in patients with SAPS. LEVEL OF EVIDENCE: II.
RCT Entities:
PURPOSE:Subacromial pain syndrome is a common disorder. Arthroscopic subacromial decompression is currently the preferred treatment method. Bipolar radiofrequency microtenotomy has shown promising results in treating tendinosis. In this study, the authors compare the results after arthroscopic acromioplasty with bipolar radiofrequency microtenotomy for patients with subacromial pain syndrome. METHODS: A total of 27 patients, with subacromial pain syndrome, were followed for 2 years. There were 14 patients in the arthroscopic acromioplasty group and 13 patients in the radiofrequency microtenotomy group. Clinical outcome data included pain reported using a visual analog scale, Constant score, and strength. Magnetic resonance imaging of the affected shoulder was performed before and 2 years after intervention for an evaluation of the tendinosis grade. RESULTS: All patients attended the final follow-up 2 years after intervention. No significant differences were found at baseline between the groups. Pain measured by the visual analog scale revealed a significant reduction in both groups at 12 weeks, 6 months and 2 years compared with baseline. There was no significant difference between the groups in terms of visual analog scale, Constant score, or strength. The magnetic resonance imaging revealed a significant improvement in the tendinosis score in both groups, without any significant difference between the groups. CONCLUSION: In this prospective randomized study, the clinical assessments revealed a significant improvement in terms of the visual analog scale, strength, Constant score, and tendinosis score 2 years after intervention with either arthroscopic acromioplasty or radiofrequency microtenotomy in patients with subacromial pain syndrome. However, no significant differences were found between the groups. This study reveals that there are surgical options other than acromioplasty in patients with SAPS. LEVEL OF EVIDENCE: II.
Authors: J I Brox; E Gjengedal; G Uppheim; A S Bøhmer; J I Brevik; A E Ljunggren; P H Staff Journal: J Shoulder Elbow Surg Date: 1999 Mar-Apr Impact factor: 3.019
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