Arthroscopic subacromial decompression: outcome comparison between outpatient and hospitalized patients with 2- to 5-year follow-up.
OBJECTIVE
The purpose of this study was to evaluate the mid-term result of the arthroscopic subacromial decompression after failed conservative treatment of shoulder pain caused by subacromial impingement, when the patients were treated as an outpatient way or by staying overnight in hospital after surgery (hospitalized patients). Our hypothesis was that the results would be equal in both groups.


METHODS
Arthroscopic subacromial decompression was performed in 80 consecutive patients, of which 40 patients were treated as an outpatient way (Outpatient Group), and 40 patients as a hospitalized way (Hospitalized Group). A prospective, comparative 2- to 5-year follow-up study including clinical examination, radiographic evaluation, isometric elevation strength measurements, as well as the University of California, Los Angeles (UCLA) and Constant shoulder scores was performed in 74 patients (93%).


RESULTS
Preoperatively, the mean UCLA score was 19 (SD 3) in the Outpatient Group, and 19 (SD 3) in the Hospitalized Group. Respectively, the mean Constant scores were 62 (SD 10) and 60 (SD 11). At the follow-up, the mean UCLA score was 32 (SD 4) in the Outpatient Group, and 32 (SD 3) in the Hospitalized Group, which both indicated good clinical outcome. Respectively, the mean Constant scores were 95 (SD 7) and 92 (SD 11), which both indicated excellent clinical outcome. At the follow-up, the UCLA and the Constant shoulder scores were significantly bet-ter than preoperatively in both groups (p < 0.01, p < 0.01), although no differences were found between the groups.The duration of the sick leaves and ability to return to work were similar in both groups. Also, the isometric elevation strengths of the operated shoulders were equally good in both groups.


CONCLUSIONS
According to this study, the results of arthroscopic subacromial decompression were equally good whether the patient was treated as an outpatient way or by staying over-night in hospital after surgery. The results were significantly better at follow-up than preoperatively in both groups. Key words: Shoulder pain; subacromial impingement; arthroscopic subacromial decompression; outpatient unit; hospitalized patient; clinical result.
Järvelä
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S
Orthopaedic Department and Arthroscopic Centre, Hatanpää Hospital, Tampere, Finland. sally.jarvela@sci.fi
Järvelä
T
T
Aho
H
H
Kiviranta
I
I
D000328:Adult; D000556:Ambulatory Surgical Procedures; D001182:Arthroscopy; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D016059:Range of Motion, Articular; D020127:Recovery of Function; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome