Arthroscopic sub-acromial decompression

Hi I found this article today regarding shoulder operations and in particular to the one mentioned below which I had done 2 weeks ago.

Oxford researchers to investigate value of keyhole shoulder operations

Published on 11 January 2012

Researchers in Oxford are hoping to find out if a commonly-performed operation used to treat shoulder pain actually works – or whether its success can be attributed to the placebo effect.

The use of a surgical technique called arthroscopic sub-acromial decompression has increased by more than 700 per cent in the past ten years but there is no hard evidence to show how effective it is. There is a growing concern that the vast increase in the frequency of the operation being performed needs to be justified.

Now a team at Nuffield Orthopaedic Centre, part of the Oxford University Hospitals NHS Trust, led by Professors David Beard and Andrew Carr are to run a clinical trial, funded by a grant of almost £200,000 from medical research charity Arthritis Research UK, comparing the effectiveness of the operation with a placebo operation.

Up to 300 patients who have had shoulder pain for over two years are to be recruited from ten centres around the UK to take part in the trial.

“Around 14 per cent of people in the UK will have a shoulder complaint, and shoulder tendon injury and sub-acromial pain account for about 70 per cent of their problems and can also lead to arthritis,”explained research nurse and trial co-ordinator Cushla Cooper.

There are a number of conflicting views about the effectiveness of surgery for shoulder pain.

While some reports show that arthroscopic or keyhole surgery is no more effective than physiotherapy to relieve pain, others show that it can be helpful and provide a useful treatment option. Other results suggest that removing a piece of bony spur from the shoulder - a procedure known as decompression – during surgery may be unnecessary, and that actual process of undergoing investigative arthroscopy can in itself produce benefit.

“The fact that a period of no treatment can also be beneficial for patients completes a rather confused picture,” added Ms Cooper. “It’s quite clear that we need to perform some definitive studies to show what really helps people with this type of shoulder pain. Pressures in the NHS are such that surgeons are being encouraged to prove the benefits of their practice, so that’s what we hope to do in this study.”

Patients will be split into three trial arms: one group undergoing arthroscopic surgery with the bony spur removed; the second having a simple arthroscopy and the third having non-operative treatment involving advice and pain relief. Their pain levels will be assessed after six and 12 months

Read the full article at arthritisresearchuk.org