Beard DJ et al
Lancet v391,(10118) p329–338, 27 January 2018 DOI 10.1016/s0140-6736(17)32457-1
- A multicentre, randomised, pragmatic, parallel group, placebo-controlled, three-group trial was carried out at 32 hospitals in the UK with 51 surgeons. Participants were patients who had subacromial pain for at least 3 months with intact rotator cuff tendons, were eligible for arthroscopic surgery, and had previously completed a non-operative management programme that included exercise therapy and at least one steroid injection.
- Between Sept 14, 2012, and June 16, 2015, 313 patients were randomly assigned to treatment groups (106 to decompression surgery, 103 to arthroscopy only, and 104 to no treatment). At 6 months, data for the Oxford Shoulder Score were available for 90 patients assigned to decompression, 94 to arthroscopy, and 90 to no treatment. Mean Oxford Shoulder Score did not differ between the two surgical groups at 6 months.
- The authors conclude that:
- Surgical groups had better outcomes for shoulder pain and function compared with no treatment but this difference was not clinically important. Additionally, surgical decompression appeared to offer no extra benefit over arthroscopy only.
- The difference between the surgical groups and no treatment might be the result of, for instance, a placebo effect or postoperative physiotherapy.
