Arthroscopic Subacromial decompression vs conservative management in subacromial impingement- A prospective comparative study

Subacromial impingement syndrome (SAIS) is one of the most common causes of shoulder pain, accounting for nearly 44–65% of shoulder disorders. It occurs due to compression of the rotator cuff tendons beneath the acromion, leading to inflammation and bursitis. While both conservative treatment and arthroscopic subacromial decompression (ASD) are widely used, there is ongoing debate regarding which approach offers superior functional outcomes.

Aim:

To compare the functional outcomes of arthroscopic subacromial decompression versus conservative management in patients with subacromial impingement.

Study Design:

A prospective randomized controlled trial conducted among adults aged 20–60 years diagnosed clinically and radiologically with subacromial impingement. A total of 60 patients were randomized into two equal groups: one receiving arthroscopic decompression and the other undergoing conservative management (physiotherapy, anti-inflammatory medication, subacromial injections).

Methodology:

Block randomization was employed. Functional outcomes were assessed at 3 weeks, 6 weeks, 3 months, and 6 months using the Constant Score, American Shoulder and Elbow Surgeons (ASES) Score, and SF-36 questionnaire.

Inclusion and exclusion criteria ensured homogeneity and eliminated confounding factors such as rotator cuff tears, arthritis, or prior shoulder surgery.

Ethical Considerations:

Ethical approval was obtained, and informed consent was secured from all participants. Confidentiality and the right to withdraw at any stage were ensured.

Expected Outcomes:

It is hypothesized that arthroscopic subacromial decompression will provide better pain relief, improved range of motion, and superior functional recovery compared to conservative management, though both methods have individual merits.

Significance:

This study aims to provide evidence-based clarity on the optimal management strategy for subacromial impingement, guiding clinicians toward more effective, patient-centered treatment decisions.