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Earlier this year, Beard et al 1 published the outcomes of a multicentre, placebo-controlled randomised surgical trial in The Lancet, in which they concluded that arthroscopic subacromial decompression has little or no benefits over placebo surgery for the treatment of subacromial shoulder pain. The article instigated heated debates among orthopaedic surgeons and sports physicians, including a critical response in the same journal by Schreurs and van der Pas,2 and a full editorial in the British Journal of Sports Medicine by Littlewood et al. 3 While we agree with many of the points raised, in both the original publication and subsequent correspondence, we are concerned about overinterpretation of these texts to invalidate or discredit subacromial decompression as a primary or adjuvant procedure, based on short-term data and regardless of the aetiologies treated.
Subacromial decompression comprises three main steps, namely ‘removal of bursa and soft tissues within the subacromial space, release of the coracoacromial ligament, and …
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