Sunday, March 3, 2013

Impingement, acromioplasty and sick leave

Arthroscopic subacromial decompression and predictors of long-term sick leave benefit and permanent benefits

While the authors state in their introduction that "Shoulder impingement syndrome is a common musculoskeletal complaint leading to reduced work ability", we have previously pointed out that we no longer should use the term "impingement" in that it lacks specificity.  While the authors do not state the criteria they used to make this diagnosis, we know that it is problematic to assign this term to non-specific shoulder pain, especially in those with work related claims. As shown in this article, acromioplasty has not been shown to be superior to non-operative measures in treating what has been referred to as 'impingment syndrome'

This study included 615 individuals undergoing arthroscopic acromioplasty.  At 1 year after surgery 16.6% of the patients were receiving sick leave benefit. . At 5 years after surgery 22.6% were receiving permanent benefit. The strongest predictor of long-term sick leave benefit and permanent benefit was opioid use during the first year after the procedure.

Work-related shoulder issues are complex, as we've noted in the past. It is important to avoid non-specific diagnoses in those with job related claims.


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