Lars Blønd1, Simone Rechter. 1. Department of Orthopaedic Surgery, Gildhøj Private Hospital, Copenhagen, Denmark, lars-blond@dadlnet.dk.
Abstract
PURPOSE: Painful snapping scapula can be a disabling condition. The object of this prospective study was to assess the efficiency of arthroscopic bone resection of the medial superior corner of scapula, in patients suffering from continuously painful snapping scapula. METHODS: Twenty patients with painful snapping scapula underwent arthroscopic scapulothoracic bursectomi and resection of the hook formation at the medial superior margin of the scapular. Preoperatively, all patients reported temporary relief via a local anesthetic injection and had completed a 3-month rehabilitation program. The Western Ontario Rotator Cuff index (WORC) was used for the assessment of pain and function levels both pre- and postoperatively. RESULTS: Twenty patients (13 women and 7 men) were included. The mean follow-up was 2.9 years (range 2-5 years). The mean age was 40 years (range 19-68 years). The mean duration of symptoms was 4 years (range 4 months-20 years). Seven previously had arthroscopic operations in the affected shoulder with acromioplasty, with or without acromioclavicular joint resection. The median preoperative WORC score was 35.0 (range 18-74) and significantly increased to 86.4 (range 33-100) postoperatively. Out of 20 patients, 18 improved and 19 indicated that they would undergo the surgery again. CONCLUSION: In this study, it was found that, among patients troubled by painful snapping scapula and without relief by exercise-based rehabilitation, arthroscopic resection of the medial superior hook formation in combination with partial bursectomy provides a serious gain in respect to the WORC score and is believed to be an effective treatment in most cases. One patient had a serious complication.
PURPOSE: Painful snapping scapula can be a disabling condition. The object of this prospective study was to assess the efficiency of arthroscopic bone resection of the medial superior corner of scapula, in patients suffering from continuously painful snapping scapula. METHODS: Twenty patients with painful snapping scapula underwent arthroscopic scapulothoracic bursectomi and resection of the hook formation at the medial superior margin of the scapular. Preoperatively, all patients reported temporary relief via a local anesthetic injection and had completed a 3-month rehabilitation program. The Western Ontario Rotator Cuff index (WORC) was used for the assessment of pain and function levels both pre- and postoperatively. RESULTS: Twenty patients (13 women and 7 men) were included. The mean follow-up was 2.9 years (range 2-5 years). The mean age was 40 years (range 19-68 years). The mean duration of symptoms was 4 years (range 4 months-20 years). Seven previously had arthroscopic operations in the affected shoulder with acromioplasty, with or without acromioclavicular joint resection. The median preoperative WORC score was 35.0 (range 18-74) and significantly increased to 86.4 (range 33-100) postoperatively. Out of 20 patients, 18 improved and 19 indicated that they would undergo the surgery again. CONCLUSION: In this study, it was found that, among patients troubled by painful snapping scapula and without relief by exercise-based rehabilitation, arthroscopic resection of the medial superior hook formation in combination with partial bursectomy provides a serious gain in respect to the WORC score and is believed to be an effective treatment in most cases. One patient had a serious complication.