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Subacromial decompression

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
Chris Littlewood, Julie Bury, Aidan O'Shea, Karen McCreesh, Kieran O'Sullivan
No abstract text is available yet for this article.
March 8, 2018: British Journal of Sports Medicine
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
Alan M Hirahara, Wyatt J Andersen
PASTA (partial articular supraspinatus tendon avulsion) lesions of greater than 50% thickness are usually repaired, whereas those of less than 50% thickness receive subacromial decompression and debridement. However, tears of greater than 25% thickness of the tendon result in increased strain of the adjacent, intact tendon fibers. Re-creating the tendon footprint at the greater tuberosity is the goal of a repair. Transtendon repairs have been considered the gold standard in repair but have shown varying outcomes and are technically difficult procedures...
October 2017: Arthroscopy Techniques
John D Higgins, Rachel M Frank, Jason T Hamamoto, Matthew T Provencher, Anthony A Romeo, Nikhil N Verma
Arthroscopic shoulder surgery can be performed in both the beach chair and lateral decubitus positions. The beach chair position is a reliable, safe, and effective position to perform nearly all types of shoulder arthroscopic procedures. The advantages of the beach chair position include the ease of setup, limited brachial plexus stress, increased glenohumeral and subacromial visualization, anesthesia flexibility, and the ability to easily convert to an open procedure. This position is most commonly used for rotator cuff repair, subacromial decompression, and superior labrum anterior-to-posterior repair procedures...
August 2017: Arthroscopy Techniques
Michelle Yagnatovsky, Amos Z Dai, Michael Zacchilli, Laith M Jazrawi
A 29-year-old female with a history of polycystic ovary syndrome (PCOS) on combined oral contraceptives presents with an acute, CT confirmed pulmonary embolus of the right lower lobe one week following arthroscopic labral repair of the right shoulder. The patient's risk factors including obesity, oral contraceptive use, PCOS, and surgical positioning are discussed.
December 21, 2017: Physician and Sportsmedicine
Christina Garving, Sascha Jakob, Isabel Bauer, Rudolph Nadjar, Ulrich H Brunner
BACKGROUND: Shoulder pain is the third most common musculoskeletal complaint in orthopedic practice. It is usually due to a defect of the rotator cuff and/or an impingement syndrome. METHODS: This review is based on pertinent literature retrieved by a selective search of the Medline database. RESULTS: Patients with shoulder impingement syndrome suffer from painful entrapment of soft tissue whenever they elevate the arm. The pathological mechanism is a structural narrowing in the subacromial space...
November 10, 2017: Deutsches Ärzteblatt International
David J Beard, Jonathan L Rees, Jonathan A Cook, Ines Rombach, Cushla Cooper, Naomi Merritt, Beverly A Shirkey, Jenny L Donovan, Stephen Gwilym, Julian Savulescu, Jane Moser, Alastair Gray, Marcus Jepson, Irene Tracey, Andrew Judge, Karolina Wartolowska, Andrew J Carr
BACKGROUND: Arthroscopic sub-acromial decompression (decompressing the sub-acromial space by removing bone spurs and soft tissue arthroscopically) is a common surgery for subacromial shoulder pain, but its effectiveness is uncertain. We did a study to assess its effectiveness and to investigate the mechanism for surgical decompression. METHODS: We did a multicentre, randomised, pragmatic, parallel group, placebo-controlled, three-group trial at 32 hospitals in the UK with 51 surgeons...
January 27, 2018: Lancet
Gernot Lang, Kaywan Izadpanah, Eva Johanna Kubosch, Dirk Maier, Norbert Südkamp, Peter Ogon
BACKGROUND: Glenohumeral exploration is routinely performed during arthroscopic removal of rotator cuff calcifications in patients with calcific tendinitis of the shoulder (CTS). However, evidence on the prevalence of intraarticular co-pathologies is lacking and the benefit of glenohumeral exploration remains elusive. The aim of the present study was to assess and quantify intraoperative pathologies during arthroscopic removal of rotator cuff calcifications in order to determine whether standardized diagnostic glenohumeral exploration appears justified in CTS patients...
November 21, 2017: BMC Musculoskeletal Disorders
Theodore F Schlegel, Jeffrey S Abrams, Brandon D Bushnell, J Logan Brock, Charles P Ho
BACKGROUND: Treatment of partial-thickness cuff tears remains controversial. Although conservative therapy may treat symptoms, these defects do not spontaneously heal and conversion to a full-thickness lesion with subsequent repair may alter the tendon footprint. The ability to induce new tissue formation and limit tear progression in intermediate- and high-grade partial-thickness tears without surgical repair may represent a significant advancement in the treatment paradigm for these lesions...
November 17, 2017: Journal of Shoulder and Elbow Surgery
Andrew R Jensen, Peter S Cha, Sai K Devana, Chad Ishmael, Theo Di Pauli von Treuheim, Anthony D'Oro, Jeffrey C Wang, David R McAllister, Frank A Petrigliano
BACKGROUND: Medicare insures the largest population of patients at risk for rotator cuff tears in the United States. PURPOSE: To evaluate the trends in incidence, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in Medicare patients. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: All Medicare patients who had undergone open or arthroscopic rotator cuff repair from 2005 through 2011 were identified with a claims database...
October 2017: Orthopaedic Journal of Sports Medicine
U L Fahlenkamp, C Gerhardt, K-G A Hermann
Even primary diagnostic evaluation of the shoulder is a challenge for radiologists. Many imaging findings that definitely indicate abnormal findings in the untreated shoulder should be evaluated carefully in postoperative patients. Artifacts caused by implants or metal abrasion pose considerable problems in postoperative magnetic resonance imaging (MRI). Classic approaches to minimizing artifacts caused by foreign bodies include using turbo spin echo sequences, increasing bandwidth, and reducing voxel size...
November 2017: Der Radiologe
Robert Z Tashjian, Jeffrey Belisle, Sean Baran, Erin K Granger, Richard E Nelson, Robert T Burks, Patrick E Greis
BACKGROUND: Very limited information exists about factors affecting direct clinical costs of rotator cuff repair surgery. The purpose of this study was to determine the direct cost of outpatient arthroscopic rotator cuff repair surgery using a unique value-driven outcomes tool and to identify patient- and treatment-related variables affecting cost. METHODS: Cost data were derived for arthroscopic rotator cuff repairs performed by 3 surgeons from March 2014 to June 2015 using the value-driven outcomes tool...
September 28, 2017: Journal of Shoulder and Elbow Surgery
Ehud Atoun, Ron Gilat, Alexander van Tongel, Riten Pradhan, Ornit Cohen, Ehud Rath, Ofer Levy
BACKGROUND: Defining a simple and reliable classification for acromial and bursal impingement lesions is necessary to standardize terminology, to improve communication, and to allow better evaluation of the proper treatment of impingement lesions and rotator cuff tears. The purpose of this study was to assess orthopedic surgeons' intraobserver and interobserver reliability of the Copeland-Levy classification. METHODS: Six fellowship-trained orthopedic surgeons reviewed shoulder arthroscopy videos of 69 consecutive patients who underwent shoulder arthroscopy for rotator cuff tear repair or subacromial decompression...
December 2017: Journal of Shoulder and Elbow Surgery
Xavier Bayle, Thuy-Trang Pham, Marie Faruch, Aurelie Gobet, Pierre Mansat, Nicolas Bonnevialle
PURPOSE: Arthroscopic techniques tend to become the gold standard in rotator cuff repair. However, little data are reported in the literature regarding the improvement of postoperative outcomes and re-tear rate relative to conventional open surgery. The aim of this study was to compare clinical outcomes and cuff integrity after arthroscopic versus open cuff repair. METHODS: We prospectively assessed clinical outcomes and cuff integrity after an arthroscopic or open rotator cuff repair with a minimum follow-up of 12 months...
December 2017: Archives of Orthopaedic and Trauma Surgery
Matthew Siow, Germaine Cuff, Jovan Popovic, Joseph Bosco
INTRODUCTION: The value proposition of surgery at freestanding ambulatory surgery centers (FSASCs) in terms of efficiency, safety, and patient satisfaction is well established and has led to increased FSASC utilization. However, there are comorbid conditions that disqualify certain patients from surgery at FSASCs. Understanding the percentage of patients whose comorbid conditions exclude them from FSASCs is important for the proper planning and utilization of operating room assets. We aim to understand the percentage of excluded patients, and we predict that certain procedures have higher rates of disqualification due to the types of patients who undergo them...
May 2017: Bulletin of the Hospital for Joint Diseases
Matthew J Kraeutler, Eric C McCarty, Jonathan T Bravman
BACKGROUND: With increased publication rates across all fields of medicine, some research topics become heavily weighted in the literature while other, equally important topics do not receive the same exposure. The purpose of this study is to present a simple equation which can be used to measure the current level of research interest on any particular surgical procedure or medical diagnosis. METHODS: The SIP Index (surgical incidence/ publications) is calculated as shown below, [Formula: see text]where X can be any particular surgical procedure...
2017: Iowa Orthopaedic Journal
Scott T Watson, Christopher B Robbins, Asheesh Bedi, James E Carpenter, Joel J Gagnier, Bruce S Miller
PURPOSE: To compare the outcomes of patients who undergo a long head of the biceps (LHB) procedure (tenotomy or tenodesis) concomitant with rotator cuff repair (RCR) to those of patients who undergo isolated RCR. METHODS: Prospectively collected data were retrospectively reviewed on 80 patients, >18 years old, who underwent repair of a full-thickness rotator cuff tear and with 1-year patient-reported outcome scores collected June 2012 to March 2015. The exclusion criteria were concomitant procedures other than LHB tenotomy, tenodesis, or subacromial decompression; prior shoulder surgery; or other shoulder pathology...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Uli Schmiddem, N Hawi, E M Suero, R Meller
INTRODUCTION: We report a case of a lost metal platelet from a radiofrequency ablation probe (VAPR VUE Radiofrequency System, Cool Pulse 90, DePuy, Synthes, Switzerland) in the shoulder joint during elective arthroscopic cuff repair. To the best of our knowledge, this kind of an incident during elective arthroscopy has not been described in the literature so far. In addition, we present an algorithm on how to deal with such an incident. CASE REPORT: A 69-year-old woman underwent an arthroscopic subacromial decompression and rotator cuff repair for a torn supraspinatus tendon...
March 2017: Journal of Orthopaedic Case Reports
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