Does arthroscopic subacromial decompression improve quality of life.
BACKGROUND
There has been a significant rise in the volume of subacromial decompression surgery performed in the UK. This study aimed to determine whether arthroscopic subacromial decompression improves health related quality of life in a cost effective manner.


METHODS
Patients undergoing arthroscopic subacromial decompression surgery for impingement were enrolled between 2012 and 2014. The Oxford shoulder score and the EQ-5D™ instruments were completed prior to and following surgery. A cost-utility analysis was performed.


RESULTS
Eighty-three patients were eligible for the study with a mean follow-up duration of 15 months (range: 4-27 months). The mean Oxford shoulder score improved by 13 points (95% confidence interval [CI]: 11-15 points). The mean health utility gain extrapolated from the EQ-5D™ questionnaire improved by 0.23 (95% CI: 0.16-0.30), translating to a minimum cost per QALY of £5,683.


CONCLUSIONS
Subacromial decompression leads to significant improvement in function and quality of life in a cost effective manner. This provides justification for its ongoing practice by appropriately trained shoulder surgeons in correctly selected patients.
Central Manchester University Hospitals NHS Foundation Trust , UK.
U
U
Butt
Central Manchester University Hospitals NHS Foundation Trust , UK.
A
A
Whiteman
Central Manchester University Hospitals NHS Foundation Trust , UK.
J
J
Wilson
Central Manchester University Hospitals NHS Foundation Trust , UK.
E
E
Paul
Central Manchester University Hospitals NHS Foundation Trust , UK.
B
B
Roy
D000174:Acromion / Q000601:surgery*; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D019299:Decompression, Surgical / Q000191:economics / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D019534:Shoulder Impingement Syndrome / Q000191:economics / Q000523:psychology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
Cost effectiveness; Cost–utility; Impingement; Patient reported outcome measures; Subacromial decompression