Arthroscopic subacromial decompression results in normal shoulder function after two years in less than 50% of patients

INTRODUCTION: The aim of this study was to evaluate the outcome two years after arthroscopic subacromial decompression using the Western Ontario Rotator-Cuff (WORC) index and a diagram-based questionnaire to self-assess active shoulder range of motion (ROM).

METHODS: Outcomes in 80 patients with impingement of the shoulder undergoing arthroscopic subacromial decompression were prospectively assessed preoperatively, at three months and at two years post-operatively using the WORC index. All patients had received non-operative treatment for at least six months before undergoing surgery. Active range of motion was measured preoperatively by the examining physician and at two years by the patient him-/herself using a diagram-based questionnaire to self-assess active shoulder ROM. A total of 75 patients (94%), of whom 31 were women, completed the study. The median age was 56 years. In all, 31 patients had additional resection of the acromioclavicular joint.

RESULTS: WORC scores improved significantly from preoperatively (median: 1,392) to three months (median: 204) and two years post-operatively (median: 243) (p < 0.001). A clinically significant decrease in the WORC index was observed in 83% of patients, but only 45% reported near normal or normal WORC scores, and 56% presented with a reduced active ROM at two years.

CONCLUSION: Arthroscopic subacromial decompression -appears effective in alleviating symptoms in patients with subacromial impingement who are resistant to conservative treatment, but can only be expected to restore normal shoulder function as measured by the WORC in less than 50% of the cases.

FUNDING: not relevant.

TRIAL REGISTRATION: not relevant.