Mid-term results after arthroscopic subacromial decompression (ASD) with special focus on the bias due to an application to social insurance for pension
S. Rupp et al., Mid-term results after arthroscopic subacromial decompression (ASD) with special focus on the bias due to an application to social insurance for pension, UNFALLCHIRU, 104(10), 2001, pp. 961-964
The objective was to evaluate mid-term results after arthroscopic subacromi
al decompression (ASD) with special focus on the bias due to an application
to social insurance for pension based on sickness disability.
The study group consisted of 42 patients (28 male, 14 female). ASD was perf
ormed in 1993 or 1994 for impingement stage II. The mean age was 49,5 years
. Thirty-nine patients (93%) were evaluated by an independent observer for
an average followup of 3,5 years (range 1.5-5). Patients satisfaction with
the outcome was assessed by a visual analog scale graded from 0 (extremely
dissatisfied) to 10 (extremely satisfied). The functional result was assess
ed using the Constant score.
At follow-up the mean VAS value was 6,4+/-3,4. The Constant score improved
from 49,6+/-18,5 to 84,8+/-14,3. The subgroup of patients having applied to
social insurance for pension had significantly worse results compared with
the remaining patients: VAS: 4,9+/-3,1 vs. 7,5+/-3,1; Constant-Score: 76,1
+/-12,7 vs. 88,3+/-13,5.
The fact that patients try to get benefit from social insurance based on si
ckness disability significantly biased the outcome after ASD.