Does arthroscopic subacromial decompression improve quality of life

Ann R Coll Surg Engl. 2015 Apr;97(3):221-3. doi: 10.1308/003588414X14055925061478.


Introduction: 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.

Keywords: Cost effectiveness; Cost–utility; Impingement; Patient reported outcome measures; Subacromial decompression.

MeSH terms

  • Acromion / surgery*
  • Adult
  • Aged
  • Arthroscopy / economics
  • Arthroscopy / methods*
  • Cost-Benefit Analysis
  • Decompression, Surgical / economics
  • Decompression, Surgical / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Retrospective Studies
  • Shoulder Impingement Syndrome / economics
  • Shoulder Impingement Syndrome / psychology
  • Shoulder Impingement Syndrome / surgery*
  • Time Factors
  • Treatment Outcome