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Subacromial impingment

Adam Witten, Mikkel B Clausen, Kristian Thorborg, Mikkel L Attrup, Per Hölmich
PURPOSE: Subacromial impingement syndrome (SIS) is associated with low self-reported shoulder function, impairments in shoulder strength and range of motion (ROM), and pain. It is not known how the symptomatology associated with SIS is reflected in the choice of treatment. This study compares self-reported shoulder function, shoulder strength, ROM, and pain in patients with SIS considered candidates and non-candidates for subacromial decompression (SAD). METHOD: Self-reported shoulder function (Q-DASH and SPADI), maximum isometric muscle strength in shoulder abduction (Abd-strength) and external rotation (ER-strength), active abduction ROM (Abd-ROM) and passive internal rotation ROM (IR-ROM) were measured in a consecutive cohort of patients with SIS referred to an orthopedic outpatient clinic...
March 17, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Stefanos Farfaras, Ninni Sernert, Lars Rostgard Christensen, Erling K Hallström, Jüri-Toomas Kartus
BACKGROUND: The long-term outcome after the treatment of subacromial impingement syndrome (SAIS) with either nonsurgical or surgical methods has not been thoroughly investigated. Hypothesis/Purpose: The purpose was to evaluate the long-term clinical outcome and the presence of rotator cuff injuries and osteoarthritis (OA) after the surgical and nonsurgical treatment of SAIS. The hypothesis was that, at a minimum 10 years after the initial treatment, patients who had undergone acromioplasty would have a better clinical outcome and run a lower risk of developing rotator cuff ruptures and OA as compared with those treated with physical therapy...
March 1, 2018: American Journal of Sports Medicine
Miltiadis Argyropoulos, Matthew Kent
Background: Open reduction internal fixation of displaced 3 and 4-part proximal humerus fractures is an effective treatment modality particularly for the younger age group, but it is not without complications. Fixed angled locking screw plates are the mainstay of fixation. The A.L.P.S. Proximal Humerus Plating System is a new implant that has smooth locking pegs in the place of humeral head screws to help reduce glenoid damage in the event of cut-out and is designed to sit low on the humerus in order to reduce the risk of subacromial impingement...
2018: Open Orthopaedics Journal
Kenneth M Lin, Dean Wang, Joshua S Dines
Rotator cuff disease affects a large proportion of the overall population and encompasses a wide spectrum of pathologies, including subacromial impingement, rotator cuff tendinopathy or tear, and calcific tendinitis. Various injection therapies have been used for the treatment of rotator cuff disease, including corticosteroid, prolotherapy, platelet-rich plasma, stem cells, and ultrasound-guided barbotage for calcific tendinitis. However, the existing evidence for these therapies remains controversial or sparse...
April 2018: Orthopedic Clinics of North America
Mikkel Bek Clausen, Thomas Bandholm, Michael Skovdal Rathleff, Karl Bang Christensen, Mette Kreutzfeldt Zebis, Thomas Graven-Nielsen, Per Hölmich, Kristian Thorborg
BACKGROUND: Subacromial impingement syndrome (SIS) is a painful, and often long lasting, shoulder condition affecting patient function and quality of life. In a recent study, we observed major strength impairments in shoulder external rotation and abduction (~30%) in a population of patients with pronounced and long-lasting SIS. However, the current rehabilitation of such strength impairments may be inadequate, with novel rehabilitation programmes including exercise therapy only improving external rotation strength by 4-13%...
March 2, 2018: Trials
Mikkel B Clausen, Mikas B Merrild, Adam Witten, Karl B Christensen, Mette K Zebis, Per Hölmich, Kristian Thorborg
Background: Impaired patient-reported shoulder function and pain, external-rotation strength, abduction strength, and abduction range-of-motion (ROM) is reported in patients with subacromial impingement (SIS). However, it is unknown how much strength and ROM improves in real-life practice settings with current care. Furthermore, outcomes of treatment might depend on specific rehabilitation parameters, such as the time spent on exercises (exercise-time), number of physiotherapy sessions (physio-sessions) and number of corticosteroid injections, respectively...
2018: PeerJ
Jeremy Lewis
In 1972, American orthopaedic surgeon Charles Neer published his seminal paper, "Anterior Acromioplasty for the Chronic Impingement Syndrome in the Shoulder: A Preliminary Report." It wasn't a robust scientific paper; however, it changed the direction of orthopaedic practice for the next half century. Neer argued that a primary cause of shoulder pain was attrition of the supraspinatus tendon and related structures from the overlying acromion, especially when the arm was elevated. Neer recommended surgical removal to stop the impingement, and over the last half century, it could be argued that millions of people around the globe would have undergone acromioplasty surgery to stop this portion of the bone impinging onto the soft tissues located in the subacromial space...
March 2018: Journal of Orthopaedic and Sports Physical Therapy
Antonio Cusano, Nicholas Pagani, Xinning Li
Medial scapular winging is often due to dysfunction of the serratus anterior muscle as a result of injury to the long thoracic nerve. Impairment of the serratus anterior muscle may cause uncoordinated scapulohumeral rhythm during shoulder elevation and subsequent subscapular or shoulder pain, subacromial impingement, and glenohumeral joint instability. Although long thoracic nerve injury typically resolves in 12 to 18 months after a physical therapy regimen, surgical intervention is indicated in patients who fail conservative management...
August 2017: Arthroscopy Techniques
Mehmet Cetinkaya, Muhammet Baybars Ataoglu, Mustafa Ozer, Tacettin Ayanoglu, Ali Yusuf Oner, Ulunay Kanatli
OBJECTIVES: The aim of this study was to analyse the effect of subscapularis tear on superior humeral excursion (SHE) and acromiohumeral distance (AHD). The hypothesis was that subscapularis tears do not result in superior humeral excursion. METHODS: Patients who underwent shoulder arthroscopy between August of 2011 and 2015 were reevaluated. Those with isolated Bankart lesion were used as control group and included in the Group 1, isolated full-thickness supraspinatus tear in the Group 2, isolated subscapularis tear in the Group 3, and combined subscapularis and supraspinatus tear in the Group 4...
February 13, 2018: Acta Orthopaedica et Traumatologica Turcica
Eugene Kim, Seunghee Lee, Hwa-Jae Jeong, Jai Hyung Park, Se-Jin Park, Jaewook Lee, Woosub Kim, Hee Jin Park, So Yeon Lee, Tsuyoshi Murase, Kazuomi Sugamoto, Sumika Ikemoto
BACKGROUND: The purpose of this study is to analyze the 3-dimensional scapular dyskinesis and the kinematics of a hook plate relative to the acromion after hook-plated acromioclavicular dislocation in vivo. Reported complications of acromioclavicular reduction using a hook plate include subacromial erosion and impingement. However, there are few reports of the 3-dimensional kinematics of the hook and scapula after the aforementioned surgical procedure. METHODS: We studied 15 cases of acromioclavicular dislocation treated with a hook plate and 15 contralateral normal shoulders using computed tomography in the neutral and full forward flexion positions...
February 13, 2018: Journal of Shoulder and Elbow Surgery
Lionel Pesquer, Sophie Borghol, Philippe Meyer, Mickael Ropars, Benjamin Dallaudière, Pierre Abadie
Subacromial impingement syndrome results from irritation of the tendons of the rotator cuff muscles in the subacromial space and may manifest as a range of pathologies. However, subacromial impingement is a dynamic condition for which imaging reveals predisposing factors but no pathognomonic indicators. Also, the usual imaging features of subacromial impingement may be seen in symptomatic and asymptomatic patients. Therefore, imaging is able to detect tears and describe the risk factors of impingement but cannot confirm subacromial impingement...
February 14, 2018: Skeletal Radiology
Eric J Cotter, Charles P Hannon, David Christian, Rachel M Frank, Bernard R Bach
CONTEXT: Shoulder pain and dysfunction are common, with patients presenting complaints to both primary and orthopaedic physicians. History and physical examination remain essential to creating a differential diagnosis, even as noninvasive imaging has improved. EVIDENCE ACQUISITION: Literature was obtained through keyword searches based on the pathology in question (eg, rotator cuff) and the keywords physical examination using PubMed from January 1, 1980, through September 20, 2017...
February 1, 2018: Sports Health
Caecilia Charbonnier, Sylvain Chagué, Bart Kevelham, Delphine Preissmann, Frank C Kolo, Olivier Rime, Alexandre Lädermann
PURPOSE: We present a computer-assisted planning solution "ArthroPlanner" for acromioplasty based on 3D anatomical models, computed tomography and joint kinematic simulations. METHODS: In addition to a standard static clinical evaluation (anamnesis, radiological examination), the software provides a dynamic assessment of the shoulder joint by computing in real time the joint kinematics from a database of activities of daily living. During motion, the precise bone resection (location and amount) is computed based on detected subacromial impingements, providing surgeons with precise information about the surgical procedure...
February 9, 2018: International Journal of Computer Assisted Radiology and Surgery
Manusak Boonard, Sermsak Sumanont, Alisara Arirachakaran, Punyawat Apiwatanakul, Artit Boonrod, Wichan Kanchanatawan, Jatupon Kongtharvonskul
BACKGROUND: In symptomatic tendinosis, a corticosteroid injection into the subacromial space is a palliative treatment option. This study compares high volumes (10 cc) of local anesthetic (LA) combined with triamcinolone acetate (TA) with low volumes (4 cc) of LA combined with TA to see whether the latter would provide similar pain, function and complication outcomes for subacromial injections in patients with impingement syndrome. MATERIALS AND METHODS: This single-center, randomized, single-blind, non-inferiority trial included patients with shoulder pain and positive multiple clinical tests supporting the diagnosis of impingement syndrome...
February 8, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Parisa Taheri, Farnaz Dehghan, Sahar Mousavi, Reza Solouki
Objective: Subacromial impingement syndrome is the most common cause of shoulder pain and restriction in range of motion in the world. The aim of this study was to compare the efficacy of subacromial injection of ketorolac with the injection of corticosteroid for the treatment of subacromial impingement syndrome. Methods: A total of forty patients were randomly allocated into two groups. Group A received 40 mg of methylprednisolone and Group B received 60 mg of ketorolac as a subacromial injection along with lidocaine...
October 2017: Journal of Research in Pharmacy Practice
George Sanchez, William H Rossy, Kyle P Lavery, Kevin J McHale, Marcio B Ferrari, Anthony Sanchez, Matthew T Provencher
Massive, irreparable rotator cuff tears are challenging to treat and associated with pain and severe limitation in shoulder elevation due to the proximal migration of the humeral head and, consequently, subacromial impingement. Furthermore, retraction of the tendons in combination with fat infiltration and muscular weakness results in unpredictable treatment outcomes. While conservative treatment may be warranted for low-demand patients, surgical treatment is often indicated for a successful return to activities of daily living as well as an improved quality of life...
August 2017: Arthroscopy Techniques
Georg Fieseler, Kevin G Laudner, Lars Irlenbusch, Henrike Meyer, Stephan Schulze, Karl-Stefan Delank, Souhail Hermassi, Thomas Bartels, René Schwesig
The purpose of this study was to examine the intra- and interrater reliability of measuring shoulder range of motion (ROM) and strength among patients diagnosed with subacromial impingement syndrome (SAIS). Twenty-five patients (14 female patients; mean age, 60.4± 7.84 years) diagnosed with SAIS were assessed to determine the intrarater reliability for glenohumeral ROM. Twenty-five patients (16 female patients; mean age, 60.4± 7.80 years) and 76 asymptomatic volunteers (52 female volunteers; mean age, 29...
December 2017: Journal of Exercise Rehabilitation
Omid Alizadehkhaiyat, Margaret M Roebuck, Ahmed T Makki, Simon P Frostick
Muscle fatigue affecting glenohumeral and/or scapular muscles is suggested as one of the contributing factors to the development of subacromial impingement syndrome (SAIS). Nonetheless, the fatigability of shoulder girdle muscles in association with the pathomechanics of SAIS has not been reported. This study aimed to measure and compare fatigue progression within the shoulder girdle musculature of patients and healthy controls. 75 participants including 39 patients (20 females; 19 males) and 36 healthy controls (15 females; 21 males) participated in the study...
December 7, 2017: Journal of Electromyography and Kinesiology
Afsun Nodehi Moghadam, Kianoush Abdi, Mohsen Shati, Shohreh Noorizadeh Dehkordi, Abbas Ali Keshtkar, Zahra Mosallanezhad
BACKGROUND: Scapular dyskinesis is an alteration in normal scapular position and motion. Some researchers believe that altered kinematics of the scapula subsequent to dysfunction or weakness of scapular stabilizing muscles contributes to impingement syndrome. Scapular muscle exercises are included in the rehabilitation of patients with subacromial impingement syndrome and scapular dyskinesis because the muscular system is one of the major contributors of scapular positioning both at rest and during shoulder movement, but there is considerable uncertainty relating to the relative effectiveness of such approaches on changing scapular position and motion...
December 13, 2017: JMIR Research Protocols
Omid Alizadehkhaiyat, Margaret M Roebuck, Ahmed T Makki, Simon P Frostick
Background: An aberrant upper body posture has been proposed as one of the etiological factors contributing to the development of subacromial impingement syndrome (SAIS). Clinicians have translated this supposition into assessment and rehabilitation programs despite insufficient and conflicting evidence to support this approach. Purpose: The purpose of this study was to compare several postural variables between the SAIS patients and asymptomatic healthy controls...
December 2017: International Journal of Sports Physical Therapy
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