Is radiofrequency treatment effective for shoulder impingement syndrome? A prospective randomized controlled study

Background: To determine whether radiofrequency based plasma microtenotomy has a positive effective in the treatment of shoulder impingement syndrome with cuff tendinosis. Materials and methods: Eighty patients with impingement syndrome and cuff tendinosis that were treated arthroscopically were enrolled in the study. The patients were randomly assigned to receive either arthroscopic subacromial decompression (ASD) alone (ASD group, n = 40) or arthroscopic subacromial decompression combined with radiofrequency (RF) based plasma microtenotomy (RF group, n = 40). Clinical outcome data including VAS pain score, shoulder range of motion (ROM), ASES, UCLA, Constant-Murley, and SST score were recorded preoperatively and at 3 weeks, 6 weeks, 3 months, 6 months, and 1 year postoperatively. Results: Sixty-five out of eighty patients (81.3%) were available for the final follow-up at 1 year postoperation. There were 32 patients in the ASD group and 33 in the RF group. Both treatment groups showed significantly (P = .031 in the ASD group vs P = .017 in the RF group) reduced pain 3 weeks postoperatively. Both treatment groups showed significantly improved functional scores 3 months postoperatively. Both treatment groups showed significantly improved flexion elevation (FE) and external rotation (ER) 1 year postoperatively and internal rotation (IR) 6 months postoperatively. No significant difference between the 2 groups was found in any of the outcome measurements at any time point postoperatively. Conclusion: Arthroscopic subacromial decompression is a reliable treatment for refractory impingement syndrome. The additional radiofrequency based plasma microtenotomy did not show any significant positive effects regarding pain relief, ROM, or functional recovery. (c) 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.