Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis

Tuomas Lähdeoja; Teemu Karjalainen; Jarkko Jokihaara; Paul Salamh; Lauri Kavaja; Arnav Agarwal; Marinus Winters; Rachelle Buchbinder; Gordon Guyatt; Per Olav Vandvik; Clare L Ardern

doi:10.1136/bjsports-2018-100486

Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis

Tuomas Lähdeoja, Teemu Karjalainen, Jarkko Jokihaara, Paul Salamh, Lauri Kavaja, Arnav Agarwal, Marinus Winters, Rachelle Buchbinder, Gordon Guyatt, Per Olav Vandvik, Clare L Ardern

Research output: Contribution to journal › Review article › peer-review

54 Citations (Scopus)

Abstract

OBJECTIVE: To determine the benefits and harms of subacromial decompression surgery in adult patients with subacromial pain syndrome lasting for more than 3 months.

DESIGN: Systematic review with meta-analysis.

MAIN OUTCOME MEASURES: Pain, physical function and health-related quality of life.

DATA SOURCES: Systematic searches for benefits and harms were conducted to 23 July 2018 in MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Database of Abstracts of Reviews of Effects, and Health Technology Assessment.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing subacromial decompression surgery for subacromial pain syndrome with any other treatment(s). For harms, we included prospective cohort studies.

REVIEW METHODS: Two reviewers independently determined eligibility, extracted the data and assessed the risk of bias of eligible studies. Thirty patients seeking primary or outpatient care for subacromial pain syndrome and a parallel guideline committee (BMJ Rapid Recommendations) provided input regarding systematic review design and interpretation.

RESULTS: There was high certainty evidence of no additional benefit of subacromial decompression surgery over placebo surgery in reducing pain at 1 year following surgery (mean difference [MD] -0.26, 95% CI -0.84 to 0.33, minimally important difference [MID] 1.5) or improving physical function at 1-2 years (MD 2.8, 95% CI -1.4 to 6.9, MID 8.3). There was moderate certainty evidence for no additional benefit of subacromial decompression surgery on health-related quality of life at 1 year (MD -0.03 points, 95% CI -0.11 to 0.06, MID 0.07). There was moderate certainty evidence for six serious harms per 1000 (95% CI 5 to 7) patients undergoing subacromial decompression.

CONCLUSION: Subacromial decompression surgery provided no important benefit compared with placebo surgery or exercise therapy, and probably carries a small risk of serious harms.

SYSTEMATIC REVIEWREGISTRATION NUMBER: CRD42018086862.

Original language	English
Article number	100486
Journal	British Journal of Sports Medicine
Volume	54
Issue number	11
Pages (from-to)	665–673
Number of pages	9
ISSN	0306-3674
DOIs	https://doi.org/10.1136/bjsports-2018-100486
Publication status	Published - Jun 2020

Bibliographical note

Keywords

Adult
Decompression, Surgical/adverse effects
Exercise Therapy
Humans
Postoperative Complications
Quality of Life
Shoulder Pain/surgery

Access to Document

10.1136/bjsports-2018-100486

AUB Link

Search for the material in Aalborg University Library's search engine

Cite this

Lähdeoja, T., Karjalainen, T., Jokihaara, J., Salamh, P., Kavaja, L., Agarwal, A., Winters, M., Buchbinder, R., Guyatt, G., Vandvik, P. O., & Ardern, C. L. (2020). Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis. British Journal of Sports Medicine, 54(11), 665–673. Article 100486. Advance online publication. https://doi.org/10.1136/bjsports-2018-100486

@article{e705ce574e23445b86771e06dda63bcf,

title = "Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis",

abstract = "OBJECTIVE: To determine the benefits and harms of subacromial decompression surgery in adult patients with subacromial pain syndrome lasting for more than 3 months.DESIGN: Systematic review with meta-analysis.MAIN OUTCOME MEASURES: Pain, physical function and health-related quality of life.DATA SOURCES: Systematic searches for benefits and harms were conducted to 23 July 2018 in MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Database of Abstracts of Reviews of Effects, and Health Technology Assessment.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing subacromial decompression surgery for subacromial pain syndrome with any other treatment(s). For harms, we included prospective cohort studies.REVIEW METHODS: Two reviewers independently determined eligibility, extracted the data and assessed the risk of bias of eligible studies. Thirty patients seeking primary or outpatient care for subacromial pain syndrome and a parallel guideline committee (BMJ Rapid Recommendations) provided input regarding systematic review design and interpretation.RESULTS: There was high certainty evidence of no additional benefit of subacromial decompression surgery over placebo surgery in reducing pain at 1 year following surgery (mean difference [MD] -0.26, 95% CI -0.84 to 0.33, minimally important difference [MID] 1.5) or improving physical function at 1-2 years (MD 2.8, 95% CI -1.4 to 6.9, MID 8.3). There was moderate certainty evidence for no additional benefit of subacromial decompression surgery on health-related quality of life at 1 year (MD -0.03 points, 95% CI -0.11 to 0.06, MID 0.07). There was moderate certainty evidence for six serious harms per 1000 (95% CI 5 to 7) patients undergoing subacromial decompression.CONCLUSION: Subacromial decompression surgery provided no important benefit compared with placebo surgery or exercise therapy, and probably carries a small risk of serious harms.SYSTEMATIC REVIEWREGISTRATION NUMBER: CRD42018086862.",

keywords = "Adult, Decompression, Surgical/adverse effects, Exercise Therapy, Humans, Postoperative Complications, Quality of Life, Shoulder Pain/surgery",

author = "Tuomas L{\"a}hdeoja and Teemu Karjalainen and Jarkko Jokihaara and Paul Salamh and Lauri Kavaja and Arnav Agarwal and Marinus Winters and Rachelle Buchbinder and Gordon Guyatt and Vandvik, {Per Olav} and Ardern, {Clare L}",

note = "{\textcopyright} Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2020",

month = jun,

doi = "10.1136/bjsports-2018-100486",

language = "English",

volume = "54",

pages = "665–673",

journal = "British Journal of Sports Medicine",

issn = "0306-3674",

publisher = "B M J Group",

number = "11",

}

Lähdeoja, T, Karjalainen, T, Jokihaara, J, Salamh, P, Kavaja, L, Agarwal, A, Winters, M, Buchbinder, R, Guyatt, G, Vandvik, PO & Ardern, CL 2020, 'Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis', British Journal of Sports Medicine, vol. 54, no. 11, 100486, pp. 665–673. https://doi.org/10.1136/bjsports-2018-100486

TY - JOUR

T1 - Subacromial decompression surgery for adults with shoulder pain

T2 - a systematic review with meta-analysis

AU - Lähdeoja, Tuomas

AU - Karjalainen, Teemu

AU - Jokihaara, Jarkko

AU - Salamh, Paul

AU - Kavaja, Lauri

AU - Agarwal, Arnav

AU - Winters, Marinus

AU - Buchbinder, Rachelle

AU - Guyatt, Gordon

AU - Vandvik, Per Olav

AU - Ardern, Clare L

PY - 2020/6

Y1 - 2020/6

N2 - OBJECTIVE: To determine the benefits and harms of subacromial decompression surgery in adult patients with subacromial pain syndrome lasting for more than 3 months.DESIGN: Systematic review with meta-analysis.MAIN OUTCOME MEASURES: Pain, physical function and health-related quality of life.DATA SOURCES: Systematic searches for benefits and harms were conducted to 23 July 2018 in MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Database of Abstracts of Reviews of Effects, and Health Technology Assessment.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing subacromial decompression surgery for subacromial pain syndrome with any other treatment(s). For harms, we included prospective cohort studies.REVIEW METHODS: Two reviewers independently determined eligibility, extracted the data and assessed the risk of bias of eligible studies. Thirty patients seeking primary or outpatient care for subacromial pain syndrome and a parallel guideline committee (BMJ Rapid Recommendations) provided input regarding systematic review design and interpretation.RESULTS: There was high certainty evidence of no additional benefit of subacromial decompression surgery over placebo surgery in reducing pain at 1 year following surgery (mean difference [MD] -0.26, 95% CI -0.84 to 0.33, minimally important difference [MID] 1.5) or improving physical function at 1-2 years (MD 2.8, 95% CI -1.4 to 6.9, MID 8.3). There was moderate certainty evidence for no additional benefit of subacromial decompression surgery on health-related quality of life at 1 year (MD -0.03 points, 95% CI -0.11 to 0.06, MID 0.07). There was moderate certainty evidence for six serious harms per 1000 (95% CI 5 to 7) patients undergoing subacromial decompression.CONCLUSION: Subacromial decompression surgery provided no important benefit compared with placebo surgery or exercise therapy, and probably carries a small risk of serious harms.SYSTEMATIC REVIEWREGISTRATION NUMBER: CRD42018086862.

AB - OBJECTIVE: To determine the benefits and harms of subacromial decompression surgery in adult patients with subacromial pain syndrome lasting for more than 3 months.DESIGN: Systematic review with meta-analysis.MAIN OUTCOME MEASURES: Pain, physical function and health-related quality of life.DATA SOURCES: Systematic searches for benefits and harms were conducted to 23 July 2018 in MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Database of Abstracts of Reviews of Effects, and Health Technology Assessment.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing subacromial decompression surgery for subacromial pain syndrome with any other treatment(s). For harms, we included prospective cohort studies.REVIEW METHODS: Two reviewers independently determined eligibility, extracted the data and assessed the risk of bias of eligible studies. Thirty patients seeking primary or outpatient care for subacromial pain syndrome and a parallel guideline committee (BMJ Rapid Recommendations) provided input regarding systematic review design and interpretation.RESULTS: There was high certainty evidence of no additional benefit of subacromial decompression surgery over placebo surgery in reducing pain at 1 year following surgery (mean difference [MD] -0.26, 95% CI -0.84 to 0.33, minimally important difference [MID] 1.5) or improving physical function at 1-2 years (MD 2.8, 95% CI -1.4 to 6.9, MID 8.3). There was moderate certainty evidence for no additional benefit of subacromial decompression surgery on health-related quality of life at 1 year (MD -0.03 points, 95% CI -0.11 to 0.06, MID 0.07). There was moderate certainty evidence for six serious harms per 1000 (95% CI 5 to 7) patients undergoing subacromial decompression.CONCLUSION: Subacromial decompression surgery provided no important benefit compared with placebo surgery or exercise therapy, and probably carries a small risk of serious harms.SYSTEMATIC REVIEWREGISTRATION NUMBER: CRD42018086862.

KW - Adult

KW - Decompression, Surgical/adverse effects

KW - Exercise Therapy

KW - Humans

KW - Postoperative Complications

KW - Quality of Life

KW - Shoulder Pain/surgery

UR - http://www.scopus.com/inward/record.url?scp=85060028336&partnerID=8YFLogxK

U2 - 10.1136/bjsports-2018-100486

DO - 10.1136/bjsports-2018-100486

M3 - Review article

C2 - 30647053

SN - 0306-3674

VL - 54

SP - 665

EP - 673

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

IS - 11

M1 - 100486

ER -

Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis

Abstract

Bibliographical note

Keywords

Access to Document

AUB Link

Other files and links

Fingerprint

Cite this