Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10-year follow-up of the FIMPACT randomised placebo surgery-controlled trial

In England, around 30,000 arthroscopic subacromial decompression (ASD) surgeries are performed annually, costing the NHS over £1.00bn since 2007-08. Despite this, eight randomised trials show that ASD offers no significant short- or medium-term benefits over placebo surgery or non-surgical treatments. As a result, both a BMJ Rapid Recommendation and a Cochrane review in 2019 advised against ASD. However, some guidelines, including NHS England’s Evidence-Based Interventions, still recommend it for patients with persistent symptoms.

To evaluate the long-term (10 years) efficacy of ASD, we conducted a multicentre, randomised trial comparing ASD with placebo surgery, alongside an exploratory comparison with exercise therapy. Results at two and five years have been published elsewhere.