Does arthroscopic subacromial decompression improve quality of life?

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 (TM) instruments were completed prior to and following surgery. A costutility 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 (TM) questionnaire improved by 0.23 (95% CI: 0.16-0.30), translating to a minimum cost per QALY of 5,683 pound. 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.