Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: What is the Clinical and Cost Effectiveness of Arthroscopic Sub-acromial Decompression Surgery?
Brief Summary: Shoulder problems causing pain and decreased function are very common. Many of these problems are related to the rotator cuff tendons. Shoulder arthroscopy surgery (keyhole surgery) is a common treatment for this pain. This can involve an Arthroscopic Subacromial Decompression (ASAD) an operation used to remove bony spurs which may be the cause of the pain. This procedure is widely used despite limited evidence of any effectiveness. This is a randomised controlled trial that will compare ASAD against an investigational shoulder arthroscopy (without spur removal/decompression) to indicate whether spur removal is really necessary and in turn, assessing the effectiveness of the ASAD procedure. Both surgical interventions are routine and will mirror each other except for the spur removal element. Both treatments will be compared against a control (non operative management with specialist reassessment) group to indicate whether surgery in general is effective for patients with subacromial pain. Patients randomised to either of the surgical options will be blinded to the type of surgery they have. This is a multicentre trial taking place in 10 centres in England and Wales. Two satellite studies will also take place. One will involve a subset of patients undergoing MRI scans to examine the effects of their shoulder pain on their brain transmissions. The other will involve collecting tissue samples from patients undergoing surgery.


Options:
A: Arm Label: Active physiotherapy; Type: EXPERIMENTAL; Interventions: Procedure: Physiotherapy program | Arm Label: Placebo physiotherapy; Type: PLACEBO_COMPARATOR; Interventions: Procedure: Placebo physiotherapy treatment | Intervention Type: PROCEDURE; Name: Physiotherapy program; Assigned to Arm(s): Active physiotherapy | Intervention Type: PROCEDURE; Name: Placebo physiotherapy treatment; Assigned to Arm(s): Placebo physiotherapy
B: Arm Label: A; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Physical therapy method called Supervised Exercises | Arm Label: B; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Radial Extracorporeal Shockwave Therapy | Intervention Type: PROCEDURE; Name: Physical therapy method called Supervised Exercises; Assigned to Arm(s): A | Intervention Type: PROCEDURE; Name: Radial Extracorporeal Shockwave Therapy; Assigned to Arm(s): B
C: Arm Label: Arthroscopic Sub-acromial Decompression; Type: EXPERIMENTAL; Interventions: Procedure: Arthroscopic Sub-acromial Decompression Surgery | Arm Label: Shoulder Arthroscopy; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Shoulder Arthroscopy | Arm Label: Active Monitoring with Specialist Reassessment; Type: OTHER; Interventions: Other: Active Monitoring with Specialist Reassessment | Intervention Type: PROCEDURE; Name: Arthroscopic Sub-acromial Decompression Surgery; Assigned to Arm(s): Arthroscopic Sub-acromial Decompression | Intervention Type: PROCEDURE; Name: Shoulder Arthroscopy; Assigned to Arm(s): Shoulder Arthroscopy | Intervention Type: OTHER; Name: Active Monitoring with Specialist Reassessment; Assigned to Arm(s): Active Monitoring with Specialist Reassessment
D: Arm Label: Arthroscopic acromioplasty; Type: EXPERIMENTAL; Interventions: Procedure: Arthroscopic acromioplasty or arthroscopy alone (sham) or conservative treatment (rehabilitation) | Arm Label: Sham surgery; Type: PLACEBO_COMPARATOR; Interventions: Procedure: Arthroscopic acromioplasty or arthroscopy alone (sham) or conservative treatment (rehabilitation) | Arm Label: Conservative treatment; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Arthroscopic acromioplasty or arthroscopy alone (sham) or conservative treatment (rehabilitation) | Intervention Type: PROCEDURE; Name: Arthroscopic acromioplasty or arthroscopy alone (sham) or conservative treatment (rehabilitation); Assigned to Arm(s): Arthroscopic acromioplasty, Conservative treatment, Sham surgery

Answer: C