Follow-up Result in Repairing a Type II Superior Labrum Anterior and Posterior (SLAP) Lesion when Associated with Shoulder Impingement Syndrome

Abstract Background Arthroscopic subacromial decompression is one of the most commonly performed shoulder surgeries in the world. It is performed to treat patients with suspected shoulder impingement syndrome, i.e., subacromial pain syndrome. Only few studies have specifically assessed return-to-work rates after subacromial decompression surgery. All existing evidence comes from open, unblinded study designs and this lack of blinding introduces the potential for bias. We assessed return to work and its predictors in patients with shoulder impingement syndrome in a secondary analysis of a placebo-surgery controlled trial. Methods One hundred eighty-four patients in a randomised trial had undergone arthroscopic subacromial decompression (n = 57), diagnostic arthroscopy, a placebo surgical intervention, (n = 59), or exercise therapy (n = 68). We assessed return to work, defined as having returned to work for at least two follow-up visits by the primary 24-month time point, work status at 24 and 60 months, and trajectories of return to work per follow-up time point. Patients and outcome assessors were blinded to the assignment regarding the arthroscopic subacromial decompression vs. diagnostic arthroscopy comparison. We assessed the treatment effect on the full analysis set as the difference between the groups in return-to-work rates and work status at 24 months and at 60 months using Chi-square test and the predictors of return to work with logistic regression analysis. Results There was no difference in the trajectories of return to work between the study groups. By 24 months, 50 of 57 patients (88%) had returned to work in the arthroscopic subacromial decompression group, while the respective figures were 52 of 59 (88%) in the diagnostic arthroscopy group and 61 of 68 (90%) in the exercise therapy group. No clinically relevant predictors of return to work were found. The proportion of patients at work was 80% (147/184) at 24 months and 73% (124/184) at 60 months, with no difference between the treatment groups (p-values 0.842 and 0.943, respectively). Conclusions Arthroscopic subacromial decompression provided no benefit over diagnostic arthroscopy or exercise therapy on return to work in patients with shoulder impingement syndrome. We did not find clinically relevant predictors of return to work either. Trial registration ClinicalTrials.gov identifier NCT00428870.

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Arthroscopic Treatment of a Type II Superior Labrum Anterior to Posterior (SLAP) Lesion Combined with a Bankart Lesion: Comparative Study between Debridement and Repair of Type II SLAP Lesion by the Status of Lesion

Clinics in Shoulder and Elbow ◽

10.5397/cise.2018.21.1.37 ◽

2018 ◽

Vol 21 (1) ◽

pp. 37-41

Author(s):

Sung Hyun Lee ◽

Min Su Joo ◽

Kyeong Hoon Lim ◽

Jeong Woo Kim

Keyword(s):

Range Of Motion ◽

Case Series ◽

Slap Lesion ◽

Bankart Lesion ◽

Visual Analogue Scale Pain ◽

Type Ii ◽

Slap Lesions ◽

Superior Labrum ◽

Significant Difference

BACKGROUND: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions.METHODS: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments.RESULTS: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021).CONCLUSIONS: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

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Efficacy of Platelet-Rich Plasma for Arthroscopic Treatment of Chronic Shoulder Impingement Syndrome: A Retrospective Study with a Minimum of 3 Years of Follow-Up

Journal of Orthopedics & Rheumatology ◽

10.13188/2334-2846.1000029 ◽

2016 ◽

Vol 3 (2) ◽

Keyword(s):

Retrospective Study ◽

Platelet Rich Plasma ◽

Impingement Syndrome ◽

Arthroscopic Treatment ◽

Shoulder Impingement Syndrome ◽

Shoulder Impingement

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The Effectiveness Of Routine Physiotherapy With And Without Neuromobilization In Patients With Shoulder Impingement Syndrome On Pain And Functional Disability; A Randomized Control Clinical Trial

10.21203/rs.2.17627/v1 ◽

2019 ◽

Author(s):

Muhammad Akhtar ◽

Hossein Kirimi ◽

Syed Amir Gilani ◽

Ashfaq Ahmad ◽

Asim Raza

Keyword(s):

Functional Disability ◽

Control Clinical Trial ◽

Impingement Syndrome ◽

Control Group ◽

Shoulder Impingement Syndrome ◽

Disability Score ◽

Shoulder Impingement ◽

Randomized Control ◽

Experimental Group

Abstract Background: Neuromobilization (NM) includes neurophysiological parameters that vary between clinicians. This randomized controlled trial aimed to investigate the NM on the outcomes of participants with shoulder impingement syndrome (SIS) following treatment sessions (base line to follow up). Study design: Single blinded randomized control clinical trial. Methods: Patients (80) with shoulder impingement syndrome (SIS) were asked to participate in this trial. At the first session, participants were randomly assigned to either control group (40) or experimental group (40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and functional disability score were evaluated on baseline, post treatment and after follow up. Pain was considered as primary out come and functional disability score as secondary outcome. Improvement was evaluated at post treatment and follow up. Differences in outcome between groups were evaluated with clinical improvement. Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), -2.38 to -1.25; P ˂ 0.001 and Partial ƞ2=0.33, similarly functional disability score 28.58(27.32-29.83) vs 20.10(18.84-21.36); between group difference ,5.62; 95%CI,(4.32-6.92); P˂ 0.001 and Partial ƞ2=0.49. Over all pain and functional disability score were improved among experimental group relative to control group at 11th week. Conclusion: In an experimental setting, the delivery of neuromobilization leads to significantly different outcomes in participants than in control group. Studies are still required to explore the mechanisms underlying neuromobilization effects. Trial registration: IRCT20190121042445N1, Registered 19 February 2019. Key words: shoulder impingement, neuromobilization, functional disability.

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Comparison of intra-articular injection therapy to physiotherapy techniques in management of shoulder impingement syndrome.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.06.3432 ◽

2019 ◽

Vol 26 (06) ◽

Author(s):

Hafiz Salman Saeed ◽

Muquduss Asif ◽

Muhammad Sajjad Iqbal ◽

Iqra Fayyaz

Keyword(s):

Physical Therapy ◽

Pain Scale ◽

Moderate Level ◽

Impingement Syndrome ◽

Injection Therapy ◽

Shoulder Impingement Syndrome ◽

Shoulder Impingement ◽

Numeric Rating ◽

Therapy Treatment

Background: Shoulder impingement syndrome is umbrella term that covers rotator cuff syndrome, tendinitis of muscles of rotator cuff and bursitis in shoulder region. Usually this syndrome is treated conservatively. The treatment options are corticosteroid injections, medical treatment and physical therapy, of which, the most common are injection therapy and physical therapy. Injection therapy is carried out by orthopedic surgeons. However, which treatment is most effective in terms of symptoms relieving and cost effectiveness, yet conflicting. Study Design: Randomized Controlled Trial. Setting: Independent University Hospital, Faisalabad. Period: 1stJuly 2017 to 30thJune 2018. Methods: Comparing effects of two treatments for shoulder impingement syndrome; sub armorial steroid injection, the control group and manual physical therapy, the treatment group. Primary outcomes were Shoulder Pain and Disability Index (SPADI), to measure endpoint differences. Secondary outcomes included changes in Global Rating of Change (GRC) scale and Numeric Pain Rating Scale (NPRS) scores. Trial was conducted in one clinical setup. The collected data was analyzed by Statistical Package of Social Sciences (SPSS 20.00). Results: At baseline of group physical therapy 19(95%) reported severe and 1(5%) moderate level of pain, at numeric rating pain scale. At post treatment of group injection therapy 19(95%) reported severe and 1(5%) moderate level of pain, at numeric rating pain scale. At follow up of group injection therapy 19(95%) reported severe and 1(5%) moderate level of pain, at numeric rating pain scale. At follow up of treatment physical therapy all patients mild level of pain, at numeric rating pain scale. Conclusion: Injection therapy treatment is more effective in improving shoulder impingement syndrome in terms of pain and function than that of physical therapy treatment.

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