Buchbinder Rachelle, Karjalainen Teemu V, Gorelik Alexandra
Monash University, Jyvaskyla, Finland.
Arthroscopy. 2022 Aug;38(8):2525-2528. doi: 10.1016/j.arthro.2022.03.017.
Arthroscopic treatment should no longer be offered to people with subacromial impingement. In many people, subacromial impingement (or subacromial pain syndrome) is self-limiting and may not require any specific treatment. This is evident by the fact that almost 50% of people with new-onset shoulder pain consult their primary care doctor only once. The best-available evidence from randomized controlled trials indicates that glucocorticoid injection provides rapid, modest, short-term pain relief. Exercise therapy has also been found to provide no added benefit over glucocorticoid injection. Subacromial decompression (bursectomy and acromioplasty) for subacromial pain syndrome provides no important benefit on pain, function, or health-related quality of life. Acromioplasty does not improve the outcomes of rotator cuff repair.
关节镜治疗不应再用于肩峰下撞击症患者。在许多人中,肩峰下撞击症(或肩峰下疼痛综合征)是自限性的,可能不需要任何特殊治疗。这一点从几乎50%新发肩部疼痛的患者仅咨询一次初级保健医生这一事实中可见一斑。随机对照试验中可得的最佳证据表明,糖皮质激素注射能提供快速、适度的短期疼痛缓解。运动疗法也未被发现比糖皮质激素注射有更多益处。针对肩峰下疼痛综合征进行的肩峰下减压术(滑囊切除术和肩峰成形术)在疼痛、功能或与健康相关的生活质量方面并无重要益处。肩峰成形术并不能改善肩袖修复的效果。