Outcome of Arthroscopic Subacromial Decompression for Shoulder Impingement Syndrome after a Whiplash Type Injury

Abstract

IntroductionRoad traffic accident (RTA) particularly with whiplash type injury has been associated with impingement syndrome of shoulder. However, the results of surgery for this group of patients have never been compared to the non accident group to see if the results are any different. In our study we aim to see if the results of these patients are worse after surgery as opposed to a group who did not sustain whiplash type injuries.BackgroundTo investigate the association between patients who have been involved in a Road Traffic accident sustaining a whiplash type injury presenting with impingement and asses their outcome after surgery.MethodsThe study group consisted of 13 patients. All of them where involved in a RTA where they were rear shunted and sustained a whiplash type injury. Arthroscopic subacromial decompression (ASD) was performed in 2005–09 for impingement. The mean age was 49.5 years. All patients were assessed with Oxford shoulder score preoperatively and at least twice post op (once within 3 months and once around the year mark). This group were compared with cohort of 13 consecutive patients (age and sex matched) done during the same period. Their scores were also assessed and analysed. Statistical tools were used to compare the results in the two groups.ResultsAll 13 patients had an improvement in their Oxford score over one year. While the improvement was only marginal ( p = 0.08) in the first three months it was better at the end of the year ( p = 0.04). Comparatively in the cohort who haven't been involved in RTA the improvement was more marked in the first three months ( p = 0.05) and this improvement was maintained over the year ( p = 0.03). The overall improvement in Oxford score was more in the cohort of patients who were not involved in a RTA as opposed to our study group.ConclusionThe results of the study show that even though there was an improvement in shoulder scores after an Arthroscopic Subacromial decompression it was much slower and overall results were far poorer in the study group as opposed to the controls. We conclude that caution should be used when offering ASAD for patients with Impingement following an RTA with a whiplash type injury more conservative measure should be pursued in these circumstances and if surgery is to be performed patients to be warned of prognosis.