FIMPACT

Why was this trial needed

Subacromial pain syndrome, commonly known as shoulder impingement, is the most frequent cause of shoulder pain.

Although non-operative management is the recommended first-line treatment, arthroscopic subacromial decompression (ASD) became one of the most commonly performed orthopaedic procedures worldwide.

The rationale is that removing bone from the undersurface of the acromion increases the space for the rotator cuff tendons. However, high-quality evidence has shown that ASD offers no relevant benefit compared to placebo surgery, yet it remains widely practiced.

What is the primary objective of the FIMPACT trial?

FIMPACT was designed to assess whether ASD is more effective than diagnostic arthroscopy alone (placebo surgery) in improving pain and function in patients with subacromial shoulder pain.

Where are we now?

FIMPACT is the first placebo-controlled surgical trial ever conducted in Finland, and one of the first globally in orthopaedics. The planning began in 2002, and nearly 20 years later, the first doctoral dissertation based on the project was defended by Kari Kanto.

We have published:

• The protocol article of the trial in 2017.
• 2-year results in The BMJ
• 5-year results in The British Journal of Sports Medicine
• MID and PASS study in BMC Medical Research Methodology
• Return to work analysis in BMC Musculoskeletal Disorders

The 10-year follow-up has been completed, and the results manuscript is under review. Later this year, we expect to share news about the next phase of the FIMPACT project—more details soon!

Project team

Simo Taimela – Kari Kanto – Mathias Bäck – Thomas Ibounig – Robert Björkenheim – Tomasz Czuba - Ville Haapamäki - Leena Caravitis – Pirjo Toivonen

Contributors

Antti Malmivaara - Jari Inkinen – Juha Kalske – Ilkka Sinisaari – Vesa Savolainen – Jonas Ranstam – Kalevi Hietaniemi – Timo Järvelä – Sari Karesvuori – Janne Lehtinen – Esa Läärä – Jarkko Pajarinen – Mikael Salmela – Mikko Salmela – Jyrki Salmenkivi – Harri Sintonen – Sikri Tukiainen - Vesa Lepola

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