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Update of guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopedic Association Part 2: Operative considerations and treatment of various c

9 hours ago
  • #orthopedic guidelines
  • #shoulder surgery
  • #subacromial pain syndrome
  • Updated guideline for subacromial pain syndrome (SAPS) by the Dutch Orthopedic Association, focusing on operative treatments.
  • Key conditions addressed: supraspinatus tears, biceps tendon pathology, and calcific tendinosis.
  • Recommendations include starting with exercise-based therapy for non-traumatic supraspinatus tears, considering surgery if no improvement in 3-6 months.
  • Advises against biceps tenotomy/tenodesis on healthy tendons unless necessary during cuff repair.
  • Suggests MRI for detailed assessment of tears and patient-specific factors.
  • Barbotage recommended for calcific tendinosis, with surgery reserved for persistent large calcifications.
  • Postoperative immobilization should not exceed 3 weeks.
  • Multidisciplinary, evidence-based approach using AGREE and GRADE methods.