Patients with subacromial impingement have difficulties with activities of daily living, particularly with overhead work and often have difficulty sleeping on their injured shoulder. Prior studies have demonstrated that arthroscopic decompression of patients with shoulder pain does not provide substantial improvement.
Hypothesis/purpose: The purpose of this study is to assess whether the results of arthroscopic shoulder decompression can be improved with a diagnostic injection of local anesthetic into the subacromial space as a definitive test to improve the results of arthroscopic subacromial decompression.
Study design: Cohort study
Four outcome scores (ASES Index, ASES Function, VAS and SANE) were assessed by patient surveys at five different time points (preoperatively, three months, six months, one year, two years).
43 patients underwent shoulder decompression procedures and 90.6% were followed for at least one year. Outcomes scores with at least 1 year followup were noted. VAS scores improved from 6.0 to 3.4. ASES Index score improved from 39.9 to 66.8. ASES Function improved from 12.1 to 20.3. SANE improved from 34.9 to 64. All measures were noted to have had a statistically significant improvement which exceeded the MCID.
The performance of a diagnostic subacromial injection of local anesthetic substantially improves outcome following an arthroscopic subacromial decompression in patients with intact rotator cuff tendons. This additional step helps to differentiate patients who have unrelated pain which may be related to other areas and can be confused with impingement syndrome as a cause of shoulder pain.