London Shoulder Specialist Mr Steven Corbett and colleagues have recently published an article in The Bone & Joint Journal. Entitled ‘The assault on arthroscopy: is there a middle ground?’, the article evaluates the role of shoulder surgery in light of the economic analysis of the CSAW (Can Shoulder Arthroplasty Work) trial that is also published in this issue of the journal.
The CSAW trial focused on the use – or overuse – of shoulder arthroscopy and subacromial decompression procedures.
They also reference the evidence of clinical trials investigating the role of arthroscopy in the treatment of orthopaedic conditions.
Mr Corbett and his fellow authors believe the CSAW trial is an important project and its results should be carefully considered but had some concerns with the scope of the study.
They highlight the limitations of the project, whilst welcoming further studies to help the management of patients.
The CSAW trial was supported by the British Shoulder and Elbow Society who are reviewing the current guidelines it provides to orthopaedic surgeons in the light of its findings.
The article concluded that “as a surgical community, we welcome any and all studies that explore the efficacy of operations and the surgical pathway, and will continue to engage with them.
“While there is no doubt that the overuse of arthroscopic procedures needs to be rationalized, it is still important not to withhold surgery from those who need it.”