Subakromial sıkışma sendromunda artroskopik dekopresyon ve ESWT tedavi etkinliklerinin karşılaştırılması

Uğur Onur Kasman; Tuğba Baysak Tunçay

doi:10.19161/etd.1697118

EN TR

Comparison of the effectiveness of arthroscopic decompression and ESWT in treating subacromial impingement syndrome

Abstract

Aim: The aim of this study is to compare the clinical outcomes of arthroscopic subacromial decompression surgery and Extracorporeal Shock Wave Therapy (ESWT) treatment in patients with Type 3 subacromial impingement syndrome. Materials and Methods: A total of 68 patients with subacromial impingement syndrome were included in the study, with 32 undergoing arthroscopic subacromial decompression and 36 receiving ESWT treatment. Pre- and post-treatment (one-year follow-up) shoulder scores based on the University of California, Los Angeles (UCLA) scoring system were compared. Results: The average pre-treatment UCLA shoulder score was determined to be 13.4±4.6. At the one-year follow-up after treatment, the average UCLA score improved to 26.1±5.9. In the ESWT-treated group, the pre-treatment UCLA score was 15.9±3.9, while the one-year post-treatment score was 25.1±6. In the arthroscopic subacromial decompression group, the preoperative UCLA score was 10.7±3.7, whereas the one-year postoperative score increased to 27.2±5.7. When each treatment method was analyzed individually, a statistically significant difference was found between pre- and post-treatment UCLA shoulder scores. Comparing UCLA scores between the two groups revealed that the increase in the arthroscopic subacromial decompression group was statistically greater than that in the ESWT group. Conclusion: Both ESWT treatment and arthroscopic subacromial decompression surgery are effective treatment methods for patients with Type 3 subacromial impingement syndrome. However, the effectiveness is more pronounced in arthroscopic subacromial decompression surgery compared to ESWT treatment.

Keywords

Subakromial sıkışma sendromunda artroskopik dekopresyon ve ESWT tedavi etkinliklerinin karşılaştırılması

Öz

Amaç: Omuzda subakromial sıkışma sendromu (tip 3) olan hastalarda artroskopik subakromial dekompresyon ameliyatının ve ESWT tedavisinin klinik sonuçlarının karşılaştırılması amaçlanmıştır. Gereç Yöntem: Subakromial sıkışma sendromu olan 68 hastanın 32’sine artroskopik subakromial dekompresyon ve 36’sına ESWT tedavisi yapıldı. Hastaların tedavi öncesi ve sonrası (birinci yıl) Kaliforniya Üniversitesi Los Angeles (UCLA) omuz skorlama sonuçları karşılaştırılmıştır. Bulgular: Hastaların tedavi öncesi yapılan klinik değerlendirmelerinde ortalama UCLA skoru 13,4±4,6 olarak tespit edilmiştir. Tedaviler sonrası 1 yıl kontrollerinde ortalama UCLA skoru 26,1±5,9 olarak bulunmuştur. ESWT yapılan grupta tedavi öncesi UCLA skoru 15,9±3,9 olarak bulunmuş tedavi sonrası birinci yıl kontrollerinde UCLA skoru 25,1±6 olarak bulunmuştur. Artroskopik subakromial dekompresyon yapılan grupta preoperatif dönemde UCLA skoru 10,7±3,7 iken postoperatif birinci yıl UCLA skoru 27,2±5,7 olarak tespit edilmiştir. Her iki tedavi yöntemi kendi içinde değerlendirildiğinde tedavi öncesi ve sonrası UCLA omuz skorları açısından istatistiksel anlamlı fark tespit edilmiştir. Her iki gruptaki UCLA skorları karşılaştırıldığında artroskopik subakromial dekompresyon yapılan gruptaki artışın ESWT yapılan gruptaki artışa göre istatistiksel olarak daha fazla olduğu tespit edilmiştir. Sonuç: Tip 3 subakromial sıkışma sendromu olan hastalarda hem ESWT tedavisi hem de artroskopik subakromial dekompresyon cerrahisi etkin tedavi yöntemleridir. Etkinlik artroskpik subakromial dekompresyon cerrahisinde ESWT tedavisine göre daha belirgindir.

Anahtar Kelimeler

References

Beach H, Gordon P. VIDEOS IN CLINICAL MEDICINE. Clinical Examination of the Shoulder. N Engl J Med. 2016;375(11):e24. doi:10.1056/NEJMvcm1212941
Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ. Dead men and radiologists don't lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl. 2006;88(2):116-121. doi:10.1308/003588406X94968
Ogden JA, Alvarez RG, Levitt R, Marlow M. Shock wave therapy (Orthotripsy) in musculoskeletal disorders. Clin Orthop Relat Res. 2001;(387):22-40. doi:10.1097/00003086-200106000-00005
Galasso O, Amelio E, Riccelli DA, Gasparini G. Short-term outcomes of extracorporeal shock wave therapy for the treatment of chronic non-calcific tendinopathy of the supraspinatus: a double-blind, randomized, placebo-controlled trial. BMC Musculoskelet Disord. 2012;13:86. Published 2012 Jun 6. doi:10.1186/1471-2474-13-86
Kolk A, Yang KG, Tamminga R, van der Hoeven H. Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis: a prospective randomised double-blind placebo-controlled multicentre trial. Bone Joint J. 2013;95-B(11):1521-1526. doi:10.1302/0301-620X.95B11.31879
Speed CA, Richards C, Nichols D, et al. Extracorporeal shock-wave therapy for tendonitis of the rotator cuff. A double-blind, randomised, controlled trial. J Bone Joint Surg Br. 2002;84(4):509-512. doi:10.1302/0301-620x.84b4.12318
Wang CJ, Cheng JH, Chou WY, Hsu SL, Chen JH, Huang CY. Changes of articular cartilage and subchondral bone after extracorporeal shockwave therapy in osteoarthritis of the knee. Int J Med Sci. 2017;14(3):213-223. Published 2017 Feb 23. doi:10.7150/ijms.17469
Wang FS, Wang CJ, Chen YJ, et al. Ras induction of superoxide activates ERK-dependent angiogenic transcription factor HIF-1alpha and VEGF-A expression in shock wave-stimulated osteoblasts. J Biol Chem. 2004;279(11):10331-10337. doi:10.1074/jbc.M308013200

Perlick L, Luring C, Bathis H, Perlick C, Kraft C, Diedrich O. Efficacy of extracorporal shock-wave treatment for calcific tendinitis of the shoulder: experimental and clinical results. J Orthop Sci. 2003;8(6):777-783. doi:10.1007/s00776-003-0720-0
Wang CJ, Yang KD, Wang FS, Chen HH, Wang JW. Shock wave therapy for calcific tendinitis of the shoulder: a prospective clinical study with two-year follow-up. Am J Sports Med. 2003;31(3):425-430. doi:10.1177/03635465030310031701
Loew M, Daecke W, Kusnierczak D, Rahmanzadeh M, Ewerbeck V. Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder. J Bone Joint Surg Br. 1999;81(5):863-867. doi:10.1302/0301-620x.81b5.9374
Vitale MA, Arons RR, Hurwitz S, Ahmad CS, Levine WN. The rising incidence of acromioplasty. J Bone Joint Surg Am. 2010;92(9):1842-1850. doi:10.2106/JBJS.I.01003
Büyükdoğan K, Koyuncu Ö, Aslan L, Çelik D, Demirhan M. Translation, cross-cultural adaptation, reliability, and validity of Turkish version of the university of California Los Angeles (UCLA) shoulder scale into Turkish. Disabil Rehabil. 2022;44(17):4871-4878. doi:10.1080/09638288.2021.1914754
Badıl Güloğlu S. Comparison of low-level laser treatment and extracorporeal shock wave therapy in subacromial impingement syndrome: a randomized, prospective clinical study. Lasers Med Sci. 2021;36(4):773-781. doi:10.1007/s10103-020-03093-0
Santamato A, Panza F, Notarnicola A, et al. Is Extracorporeal Shockwave Therapy Combined With Isokinetic Exercise More Effective Than Extracorporeal Shockwave Therapy Alone for Subacromial Impingement Syndrome? A Randomized Clinical Trial. J Orthop Sports Phys Ther. 2016;46(9):714-725. doi:10.2519/jospt.2016.4629
Huisstede BM, Gebremariam L, van der Sande R, Hay EM, Koes BW. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review. Man Ther. 2011;16(5):419-433. doi:10.1016/j.math.2011.02.005.
Circi E, Okur SC, Aksu O, Mumcuoglu E, Tuzuner T, Caglar N. The effectiveness of extracorporeal shockwave treatment in subacromial impingement syndrome and its relation with acromion morphology. Acta Orthop Traumatol Turc. 2018;52(1):17-21. doi:10.1016/j.aott.2017.10.007
Kvalvaag E, Roe C, Engebretsen KB, et al. One year results of a randomized controlled trial on radial Extracorporeal Shock Wave Treatment, with predictors of pain, disability and return to work in patients with subacromial pain syndrome. Eur J Phys Rehabil Med. 2018;54(3):341-350. doi:10.23736/S1973-9087.17.04748-7
Paavola M, Kanto K, Ranstam J, et al. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: a 5-year follow-up of a randomised, placebo surgery controlled clinical trial. Br J Sports Med. 2021;55(2):99-107. doi:10.1136/bjsports-2020-102216
Dorrestijn O, Stevens M, Winters JC, van der Meer K, Diercks RL. Conservative or surgical treatment for subacromial impingement syndrome? A systematic review. J Shoulder Elbow Surg. 2009;18(4):652-660. doi:10.1016/j.jse.2009.01.010
Farfaras S, Sernert N, Rostgard Christensen L, Hallström EK, Kartus JT. Subacromial Decompression Yields a Better Clinical Outcome Than Therapy Alone: A Prospective Randomized Study of Patients With a Minimum 10-Year Follow-up. Am J Sports Med. 2018;46(6):1397-1407. doi:10.1177/0363546518755759

Details

Primary Language

Turkish

Subjects

Orthopaedics

Journal Section

Research Article

Authors

Uğur Onur Kasman ^*
0000-0001-6647-2682
Türkiye

Tuğba Baysak Tunçay
0000-0003-1081-8802
Türkiye

Publication Date

September 8, 2025

Submission Date

May 19, 2025

Acceptance Date

June 9, 2025

Published in Issue

Year 2025 Volume: 64 Number: 3

DOI

https://doi.org/10.19161/etd.1697118

IZ

https://izlik.org/JA63TX44NA

Cite

RIS / Bibtex

Vancouver

1.Uğur Onur Kasman, Tuğba Baysak Tunçay. Subakromial sıkışma sendromunda artroskopik dekopresyon ve ESWT tedavi etkinliklerinin karşılaştırılması. EJM. 2025 Sep. 1;64(3):543-7. doi:10.19161/etd.1697118