An increasingly popular form of shoulder surgery has minimal benefits, according to the findings of a British randomised trial published today.
Researchers found no difference between decompression surgery and a placebo treatment for shoulder impingement in a study involving 51 surgeons and 32 hospitals.
Researchers said the findings raised questions about the value of the procedure, which has increased in popularity by nearly ten times this century. More than 21,000 people received the treatment in 2010 in the UK.
Patients who took part in the research had suffered shoulder pain for at least three months despite having physiotherapy and steroid injections.
90 underwent decompression surgery, 94 underwent placebo surgery and 90 went without treatment.
The study, reported in The Lancet, found that patients who underwent surgery reported slightly more improvement than those who had no treatment. The researchers say their findings are complicated by the long waiting times that many patients had for surgery. Waits averaged around 90 days.
Researcher Professor Andrew Carr, of Oxford University, said: "Over the past three decades, patients with this form of shoulder pain and clinicians have accepted this surgery in the belief that it provides reliable relief of symptoms, and has low risk of adverse events and complications.
“However, the findings from our study suggest that surgery might not provide a clinically significant benefit over no treatment, and that there is no benefit of decompression over placebo surgery."
Fellow researcher Professor David Beard said: “In light of our results, other ways to treat shoulder impingement could be considered, such as painkillers, physiotherapy and steroid injections."
Professor David J Beard et al. Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial. Lancet 21 November 2017 [abstract]
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