Shoulder impingement syndrome: Outcome of arthroscopic subacromial decompression in Kuantan

INTRODUCTION: Shoulder impingement syndrome is one of the common problem which leads to shoulder disabilities. Neer (1972) first to describe this condition as impingement to the rotator cuff by anterior third of the acromion process. Treatment options varies depending on grade of the impingement and rotator cuff involvement. Arthroscopic subacromial decompression (ASAD) has become more popular in recent years and have shown to have good outcomes. MATERIALS & METHODS: Patients who underwent ASAD with or without rotator cuff repair in Hospital Tengku Ampuan Afzan, Kuantan and International Islamic University Medical Centre Kuantan from September 2016 until Dec 2017 were studied. The functional outcomes were evaluated using ASES, DASH and Constant scoring system. The patients were assessed at preoperative, 3months and 6 months post ASAD. RESULTS: 10 patients were collected. 2 patients also underwent ACJ resection, 2 patients with rotator cuff repair and another 1 converted to mini open cuff repair. All patients are satisfied with their current functions and have showed good functional outcome as early as 3 months. Mean constant score at 3 months is fair (25) but at 6 months is excellent (<11). Mean ASES and DASH score showed improvement by 72% and 56% respectively at 3 months compared to preoperative condition. While at 6 months improved by 86% and 74% respectively. DISCUSSIONS: Surgical treatment is always indicated if conservative treatment failed. Options of arthroscopic or mini open with or without rotator cuff repair remains debatable. Both have shown good outcome in terms of function and study showed there were no significant different [1]. In recent years, however, arthroscopic surgery became more popular compared to mini open as it is less invasive and proven to have good outcomes in short and long term [2][3]. Bidwai et al (2015) concluded that there is no significant benefit of cuff repair over decompression alone in partial cuff tear. Even though ASAD has proven good functional outcomes and has become more popular, it is still inconclusive whether is it the best treatment option in managing shoulder impingement syndrome. CONCLUSION: Arthroscopic subacromial decompression does give a good functional outcome in treating shoulder impingement syndrome with or without rotator cuff tear

Outcome of arthroscopic vs mini open subacromial decompression in treating shoulder impingement syndrome

Introduction: Shoulder impingement syndrome is a common diagnosis leading to shoulder disabilities. Subacromial decompression surgery either arthroscopic or mini open is indicated in patients who failed conservative therapy. Arthroscopic surgery is introduced to reduce soft tissue dissection hence less soft tissue damage and fasten rehabilitation. This study is conducted to compare the outcome of mini open and arthroscopic surgery. Materials and Methods: A cross sectional study was conducted in patients who were diagnosed with shoulder impingement syndrome with or without rotator cuff tear who underwent subacromial decompression surgery, with mini open or arthroscopic surgery at Hospital Tengku Ampuan Afzan, Kuantan. Functional outcome was assessed using American Shoulder and Elbow Surgeon (ASES) score and Constant score. Results: Six patients were recruited in the mini open group while 11 in the arthroscopic group. Of these, all were female in mini open group, aged 56.7 ± 7.9 while seven female and four male in the arthroscopic group aged 55.1 ± 9.4 (p-value 0.733). They were evaluated at 3 to 5 years after surgery in the mini open, and at six months in the arthroscopic group. There was no significant different in the ASES score in the mini open group (89.8 ± 11.7) and arthroscopic group (89.8 ±17.9), with p-value of 0.998. Constant score in the mini open was 18.67 ± 7.61, while in the arthroscopic was 16.18 ± 15.03; and there was no significant difference in this two groups (p-value 0.712). Three patients each has good and fair outcome in the mini open surgery, while six patients has excellent, two each has good and fair; and one has poor outcome in the arthroscopic surgery. Conclusion: There were no significant differences in the functional outcomes between mini open and arthroscopic subacromial decompression surgery

Outcome of arthroscopic vs mini open subacromial decompression in treating shoulder impingement syndrome

Introduction: Shoulder impingement syndrome is a common diagnosis leading to shoulder disabilities. Subacromial decompression surgery either arthroscopic or mini open is indicated in patients who failed conservative therapy. Arthroscopic surgery is introduced to reduce soft tissue dissection hence less soft tissue damage and fasten rehabilitation. This study is conducted to compare the outcome of mini open and arthroscopic surgery. Materials and Methods: A cross sectional study was conducted in patients who were diagnosed with shoulder impingement syndrome with or without rotator cuff tear who underwent subacromial decompression surgery, with mini open or arthroscopic surgery at Hospital Tengku Ampuan Afzan, Kuantan. Functional outcome was assessed using American Shoulder and Elbow Surgeon (ASES) score and Constant score. Results: Six patients were recruited in the mini open group while 11 in the arthroscopic group. Of these, all were female in mini open group, aged 56.7 ± 7.9 while seven female and four male in the arthroscopic group aged 55.1 ± 9.4 (p-value 0.733). They were evaluated at 3 to 5 years after surgery in the mini open, and at six months in the arthroscopic group. There was no significant different in the ASES score in the mini open group (89.8 ± 11.7) and arthroscopic group (89.8 ±17.9), with p-value of 0.998. Constant score in the mini open was 18.67 ± 7.61, while in the arthroscopic was 16.18 ± 15.03; and there was no significant difference in this two groups (p-value 0.712). Three patients each has good and fair outcome in the mini open surgery, while six patients has excellent, two each has good and fair; and one has poor outcome in the arthroscopic surgery. Conclusion: There were no significant differences in the functional outcomes between mini open and arthroscopic subacromial decompression surgery