The most common shoulder operation in the world did not work

Congestion syndrome or congestion syndrome is a painful condition of the shoulder. The problem is common and surveys conducted in the United States have shown that between 44 and 70% of patients with sore pain were getting this diagnosis.

Treatment often consists of exercise or anti-inflammatory drugs. But some do not get rid of the pain after such treatment. And in recent years, it has become increasingly common to use the arthroscopic subacromial decompression (ASD) method. This type of surgery has, in addition to the pure placebo effect.

Some doctors have argued that it works too much. In 2013, Professor and Head Jens Ivar Brox, for example, raised the subject in an interview with Dagens Medicin

He thought that most of these shoulder operations performed in Norway were useless.

He now receives support from a Finn. Mika Paavola and her colleagues performed a randomized, placebo-controlled, double-blind study – the benchmark for medical research

. The researchers compared two groups of patients. One was operated on by an ASD, while in the other group, the surgeon came in and examined the joint.

Researchers followed participant participation over the next two years

Neither patients nor researchers knew which of the patients had received any treatment.

No difference

Thus, there was no difference between treatment and only one study of articulation. In both cases, the patients reported mild pain two years after the surgery, but the effect was also important regardless of the intervention

Thus, it seems that the specialized procedure did not no effect on the incidence syndrome, in addition to the placebo effect. The findings do not support the current practice of performing ADS on patients with more syndrome, Paavola and co wrote in his conclusion.

Training did not work as well

The study also does not support treatment training. The researchers included a third group of patients who received a personalized workout program with home exercises and visits to the physiotherapist.

However, the results showed that ADS and kikkehole survey had a more important effect than training. weight. Of course, in this group, it was not possible to do a blind test: the patients and the researchers knew that the group had received training and not an operation.

Another point is that the patients of the survey were taken according to very specific criteria. The researchers had only included participants likely to have an effect of the surgery.

This would probably help to provide better surgical results than in a more varied group of patients.

Some participants

At the same time, Paavola and co? There are also some other weaknesses in the investigation. For example, researchers recruited a few fewer patients than they initially wanted – 59 patients in each group, at 68 desirable.

However, they believe that the study has many advantages – that it was double-blind and that they are patients

The researchers also write that their study closely matches the results of the study. a similar survey recently published in The Lancet.

The group behind this study concluded, similarly, that Paavola: [19659002] ads does not seem to have any effect on conflict syndrome, and this should be considered by patients considering the operation.

Reference:

Mika Paavola et al., Subacromial decompression versus diagnostic arthroscopy for shoulder involvement: placebo-controlled clinical trial, BMJ, July 2018