[Arthroscopic Subacromial Decompression]

Overview

Journal Oper Orthop Traumatol

Publisher Springer

Specialties Emergency Medicine
Orthopedics

Date 2016 Jun 5

PMID 27259482

Citations 3

Authors

S Lerch

S Elki

M Jaeger

T Berndt

Affiliations

Soon will be listed here.

Abstract

Objective: Coracoacromial ligament release to widen the subacromial space, resection of the anterior undersurface of the acromion and, if needed, caudal exophytes at the acromioclavicular joint.

Indications: All types of outlet impingement after 3 months of conservative treatment.

Contraindications: Impingement syndrome with instability/muscular imbalance, massive rotator cuff tear, unstable os acromionale, posterior-superior impingement, joint infection, freezing phase of a secondary frozen shoulder.

Surgical Technique: Lateral decubitus position with traction device for the arm. Diagnostic arthroscopy of the glenohumeral joint via standard portals. With arthroscope moved to the subacromial space, bursectomy, electrosurgical release of coracoacromial ligament, resection of acromial hook through standard posterior portal.

Postoperative Management: Physiotherapy or self-exercises on postoperative day 1, pain-adapted analgesia to avoid shoulder stiffness.

Results: Several studies present positive long-term results compared to conservative treatment (and open acromioplasty) for partial rotator cuff tears and for elderly patients. With a 20-year follow-up, successful results have been achieved for all patients with isolated impingement syndrome.

Citing Articles

Increased operative time has a negative impact on clinical outcome in arthroscopic rotator cuff repair.

Thery C, Antoni M, Dujeux C, Eichler D, Meyer N, Clavert P Eur J Orthop Surg Traumatol. 2023; 33(7):2865-2871.

PMID: 36879163 DOI: 10.1007/s00590-023-03487-0.

Calcifying tendinitis and outlet impingement - Evaluation of the prevalence analyzing radiological and intraoperative criteria.

Braun-Munzinger L, Berndt T, Ruhmann O, Lerch S J Orthop. 2020; 21:265-269.

PMID: 32322139 PMC: 7163050. DOI: 10.1016/j.jor.2020.03.035.

Efficacy of concomitant acromioplasty in the treatment of rotator cuff tears: A systematic review and meta-analysis.

Cheng C, Chen B, Xu H, Zhang Z, Xu W PLoS One. 2018; 13(11):e0207306.

PMID: 30439995 PMC: 6237382. DOI: 10.1371/journal.pone.0207306.

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