The Effect of Arthroscopic Subacromial Decompression in Patients Who Are Non-responders to Non-operative Treatment. (SELECT)
Subacromial Impingement Syndrome
About this trial
This is an interventional treatment trial for Subacromial Impingement Syndrome
Eligibility Criteria
Inclusion Criteria:
- SIS diagnosis (Consultant's clinical diagnosis of SIS + at least 3 out of 5 positive tests from the following: Hawkin's, Neer's, Jobe's, Painful arc and external rotation resistance test)
- Positive subacromial injection test
- Insidious onset of shoulder pain
- Considered a surgical candidate by an orthopedic shoulder specialist.
- Symptoms for at least 6 months
- Completion of at least 3 months supervised shoulder training
- No improvement in symptoms for at least 3 months
- The patient must be expected to be able to attend rehabilitation and post-examinations.
Exclusion Criteria:
- Terminal illness or severe medical illness (ASA score higher than or equal to 4), systemic musculoskeletal disease, inflammatory joint disease (e.g. rheumatoid arthritis), symptomatic cervical spine pathology or thoracic outlet syndrome.
- Full-thickness rotator cuff tear, calcified tendonitis, labral tear, frozen shoulder, biceps tendon pathology, acromioclavicular osteoarthrosis, glenohumeral osteoarthrosis or other concomitant shoulder pathology.
- Previous surgery or radiotherapy on the affected shoulder.
- Pregnancy
- Diabetes mellitus
- Ongoing workers compensation case or job rehabilitation process
Sites / Locations
- Hvidovre Univeristy HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Glenohumeral arthroscopy and arthroscopic subacromial decompression
Glenohumeral arthroscopy and skin incision
The intervention group will receive a glenohumeral arthroscopy and ASAD. Participants are discharged with an arm sling and referred to 3 months physiotherapy in a municipally setting. Participants are given a rehabilitation program containing progressive exercises to guide the rehabilitation.
The control group will receive a glenohumeral arthroscopy, but no treatment concerning the subacromial structures. To allow for the best possible blinding, a 7-10 mm incision, mimicking the one used for ASAD, is performed on the lateral side of the arm 2-3 distal to the acromion. Participants are discharged with an arm sling and referred to 3 months physiotherapy in a municipally setting. Participants are given a rehabilitation program containing progressive exercises to guide the rehabilitation.