Tuesday, 16 Jul 2019

You are here

Guidelines Recommend Against Acromioplasty

Subacromial pain iacounts for up to 70% of shoulder pain. Patients may be diagnosed with subacromial pain syndrome (SAPS), shoulder impingement, or rotator cuff disease and often end up in surgery. 

This new guideline states that subacromial decompression surgery should not be offered to patients with subacromial pain syndrome. The guidance — considered a strong recommendation — applies to patients with atraumatic shoulder pain, including rotator cuff disease, lasting longer than 3 months.

The guideline comes from the BMJ's Rapid Recommendations panel made up of patients, clinicians, and researchers.

The recommendation was based on findings from seven randomized trials among roughly 1000 patients that compared decompression surgery with either sham surgery or exercise alone.

Overall, decompression surgery did not provide a meaningful benefit over nonsurgical treatment in terms of pain, function, or quality-of-life.

Conversely, surgery was associated with more cases of frozen shoulder (12 excess cases per 1000 surgery patients).

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

RheumNow Podcast – Boiling Hot MAS (7.12.19)

Dr. Jack Cush reviews this week's news and journal reports featured on RheumNow.com. PsA v. non-PsA pregnancies, Still's disease, lupus, nutritional supplements and dietary interventions, use of cannabis, tanezumab in OA, CBD oils and more.

Be ‘on point’: Guidelines for rheumatic complications of immunotherapy

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. At EULAR 2019, Madrid, several recommendations including RA, SLE, and Sjogren’s syndrome have been developed. Agreement for principles with respect to the treatment of immune mediated adverse events from cancer immunotherapy are lacking.

RheumNow Podcast – EULAR 2019 Streamin' - (6.14.19)

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Dr. Jack Cush reports from Madrid on several novel presentations from EULAR 2019, including low-dose steroids in hand OA, ABA vs. ADA in double positive RA patients, psoriasis predictors of PsA, tildrakizumab and more.

EULAR 2019 – Day 3 Report

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. The third day of EULAR 2019 started with novel biologics, the efficacy of secukinumab in axial psoriatic arthritis, neurologic events with TNF inhibitors from the DANBIO database (OP0261), and neuropathy in SLE (OP0252), but above all this was a big poster day. Here are selected highlights from day 3 EULAR in Madrid.

Ultrasound Reveals Which Anti-CCP Positive Patients Progress to Arthritis 

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Power Doppler signal on baseline ultrasound exam may well help stratify anti-CCP positive patients with musculoskeletal symptoms but no clinical synovitis, according to data from the Leeds Institute of Rheumatic and Musculoskeletal Medicine presented at EULAR 2019.