Research Article
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The Role of Arthroscopic Decompression in Subacromial Impingement Syndrome

Year 2019, Volume: 3 Issue: 3, 248 - 253, 26.10.2019
https://doi.org/10.30565/medalanya.567430

Abstract

Aim: The aim of this study was to evaluate the clinical results of patients who had arthroscopic subacromial decompression for the diagnosis of subacromial impingement syndrome which is characterized by compression of the coracoacromial arc on rotator cuff tendons. 

Patients and Methods: We have evaluated the Constant scores, rest VAS and motion VAS scores of 25 patients who had arthroscopic subacromial decompression after six months of failed conservative treatment, at the preoperative day, 15th day and 6th month after the operation. 

Results: There was a statistically significant difference between pre-operative and 15th day / 6th month scores with Mann Whitney U test (p <0.0001). We found that the patients’ pain decreased and shoulder functions improved statistically. 

Conclusion: We believe that the choice of treatment for early stages of subacromial impingement syndrome is conservative, but if complaints persist even six months after conservative treatment, then arthroscopic subacromial decompression is a good choice of treatment. 

References

  • 1. Oates KM. Re: Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy: J Arthrosc & Relat Surg. 2010;26(1):104. DOI: 10.1016/j.arthro.2009.10.003
  • 2. Özsoy MH, Fakıoğlu O, Aydoğan NH. Subakromiyal sıkışma sendromu. TOTBİD Dergisi 2013; vv:340–352 doi: 10.14292/totbid.dergisi.2013.42
  • 3. Schippinger G, Bailey D, McNally EG, Kiss J, Carr AJ. Anatomy of the normal acromion investigated using MRI. Langenbecks Archiv für Chirurgie. 1997;382(3):141-4. PMID: 9239637
  • 4. Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S, Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am, 1988;70(8): 1224-30 PMID: 3417708
  • 5. Hirano M, Ide J, Takagi K, Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluation. J Shoulder Elbow Surg, 2002; 11(6):576-8. DOI: 10.1067/mse.2002.127097
  • 6. Shah NN, Bayliss NC, Malcolm A, Shape of the acromion: congenital or acquired-a macroscopic, radiographic, and microscopic study of acromion. J Shoulder Elbow Surg, 2001;10(4):309-16 DOI: 10.1067/mse.2001.114681
  • 7. Lewis JS, Green A, Wright C, Subacromial impingement syndrome: the role of posture and muscle imbalance. J Shoulder Elbow Surg, 2005;14(4):385-92. DOI: 10.1016/j.jse.2004.08.007
  • 8. Hagiwara Y, Kanazawa K, Ando A, Nimura A, Watanabe T, Majima K, Blood flow changes of the anterior humeral circumflex artery decrease with the scapula in internal rotation. Knee Surg Sports Traumatol Arthrosc, 2015;23(5):1467-72. DOI: 10.1007/s00167-013-2823-2
  • 9. Moseley HF, Goldie I, The Arterial Pattern of the Rotator Cuff of the Shoulder. J Bone Joint Surg Br, 1963. 45(4):780-9 PMID: 14074332
  • 10. Ko JY, Huang CC, Chen WJ, Chen CE, Chen SH, Wang CJ, Pathogenesis of partial tear of the rotator cuff: a clinical and pathologic study. J Shoulder Elbow Surg, 2006;15(3): 271-8. PMID: 16679225
  • 11. Guntern DV, Pfirrmann CW, Schmid MR, Zanetti M, Binkert CA, Schneeberger AG, Articular cartilage lesions of the glenohumeral joint: diagnostic effectiveness of MR arthrography and prevalence in patients with subacromial impingement syndrome. Radiology, 2003;226(1):165-70. PMID: 12511686
  • 12. Petersson CJ, Degeneration of the gleno-humeral joint: an anatomical study. Acta Orthop Scand, 1983;54(2):277-283. PMID: 6846007
  • 13. Singh HP, Mehta SS, Pandey R, A preoperative scoring system to select patients for arthroscopic subacromial decompression. J Shoulder Elbow Surg, 2014;23(9):1251-6. PMID: 25127909
  • 14. Watson M, Major ruptures of the rotator cuff. The results of surgical repair in 89 patients. J Bone Joint Surg Br, 1985;67(4):618-24 PMID: 4030862
  • 15. Wong MW, Tang YY, Lee SK, Fu BS, Chan BP, Chan CK, Effect of dexamethasone on cultured human tenocytes and its reversibility by platelet-derived growth factor. J Bone Joint Surg Am, 2003;85-A(10): 1914-20 . PMID: 14563798
  • 16. Yıldız V, Aydın A, Kalalı F, Yıldırım ÖS, Topal M, Aydın P, Kronik İmpingement Sendromlu Hastalarda Uygulanan Steroidin Artroskopik Subakromiyal Dekompresyon Sonrasına Klinik Etkisi. Fırat Tıp Dergisi. 2012;17(1): 32-35.
  • 17. Brox JI, Gjengedal E, Uppheim G, Bohmer AS, Brevik JI, Ljunggren AE, Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): a prospective, randomized, controlled study in 125 patients with a 2 1/2-year follow-up. J Shoulder Elbow Surg, 1999;8(2): 102-11. PMID: 10226960
  • 18. Karaman Ö, Karakuş Ö, Kaynak G, Çalışkan G, Saygı B, Artroskopik subakromiyal dekompresyon: 1-4 yıllık sonuçlar. Şişli Etfal Tıp Bülteni, 2012;46(3):136-139.
  • 19. Beard DJ, Rees JL, Cook JA, Rombach I, Cooper C, Merritt N, Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial. Lancet, 2018; 391(10118):329-338 DOI: 10.1016/S0140-6736(17)32457-1
  • 20. Bouchard A, Garret J, Favard L, Charles H, Ollat D, Failed subacromial decompression. Risk factors. Orthopaedics & Traumatology: Surgery & Research, 2014; 100(8): S365-S369 PMID: 25454330
  • 21. Bhattacharyya R, Edwards K, Wallace AW, Does arthroscopic sub-acromial decompression really work for sub-acromial impingement syndrome: a cohort study. BMC musculoskeletal disorders, 2014;15(1):324. PMCID: 4190469
  • 22. Farfaras S, Sernert N, Rostgard Christensen L, Hallström EK, Kartus JT, Subacromial decompression yields a better clinical outcome than therapy alone: a prospective randomized study of patients with a minimum 10-year follow-up. The American journal of sports medicine, 2018. 46(6):1397-1407. PMID: 29543510
  • 23. Lerch S, Elki S, Jaeger M, Berndt T, Arthroskopische subakromiale Dekompression. Operative Orthopädie und Traumatologie, 2016. 28(5):373-391 DOI: 10.1007/s00064-016-0450-z
  • 24. Jaeger M, Berndt T, Rühmann O, Lerch S, Patients with impingement syndrome with and without rotator cuff tears do well 20 years after arthroscopic subacromial decompression. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2016;32(3): 409-415. PMID: 26507160

Subakromiyal Sıkışma Sendromunda Artroskopik Tedavinin Yeri

Year 2019, Volume: 3 Issue: 3, 248 - 253, 26.10.2019
https://doi.org/10.30565/medalanya.567430

Abstract

Amaç: Bu çalışmanın amacı, rotator manşet tendonları üzerine korakoakromiyal arkın basısı ile karakterize subakromiyal sıkışma sendromu tanısı ile artroskopik subakromiyal dekompresyon yapılan hastaların klinik sonuçlarını değerlendirmektir. 

Hastalar veYöntem: En az altı ay konservatif tedavi uygulamalarından fayda görmeyen ve artroskopik subakromial dekompresyon uyguladığımız 25 hastanın, tedavi öncesi ve cerrahi sonrası 15. gün ve 6. aydaki Constant, istirahat VAS ve hareket VAS skorlarını değerlendirdik. 

Bulgular: Ameliyat öncesi ve 15. gün / 6. ay skorları arasında Mann Whitney U testi ile istatistiksel olarak anlamlı bir fark vardı (p <0.0001). Hastaların ağrılarının azaldığını ve omuz fonksiyonlarında iyileşme olduğunu istatistiksel olarak tespit ettik. 

Sonuç: Erken evre subakromial sıkışma sendromunun tedavisinin konservatif olduğu; ancak, 6 ay konservatif tedaviye rağmen şikayetleri devam eden hastalarda artroskopik subakromial dekompresyonun iyi bir tedavi seçeneği olduğu kanaatindeyiz. 

References

  • 1. Oates KM. Re: Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy: J Arthrosc & Relat Surg. 2010;26(1):104. DOI: 10.1016/j.arthro.2009.10.003
  • 2. Özsoy MH, Fakıoğlu O, Aydoğan NH. Subakromiyal sıkışma sendromu. TOTBİD Dergisi 2013; vv:340–352 doi: 10.14292/totbid.dergisi.2013.42
  • 3. Schippinger G, Bailey D, McNally EG, Kiss J, Carr AJ. Anatomy of the normal acromion investigated using MRI. Langenbecks Archiv für Chirurgie. 1997;382(3):141-4. PMID: 9239637
  • 4. Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S, Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am, 1988;70(8): 1224-30 PMID: 3417708
  • 5. Hirano M, Ide J, Takagi K, Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluation. J Shoulder Elbow Surg, 2002; 11(6):576-8. DOI: 10.1067/mse.2002.127097
  • 6. Shah NN, Bayliss NC, Malcolm A, Shape of the acromion: congenital or acquired-a macroscopic, radiographic, and microscopic study of acromion. J Shoulder Elbow Surg, 2001;10(4):309-16 DOI: 10.1067/mse.2001.114681
  • 7. Lewis JS, Green A, Wright C, Subacromial impingement syndrome: the role of posture and muscle imbalance. J Shoulder Elbow Surg, 2005;14(4):385-92. DOI: 10.1016/j.jse.2004.08.007
  • 8. Hagiwara Y, Kanazawa K, Ando A, Nimura A, Watanabe T, Majima K, Blood flow changes of the anterior humeral circumflex artery decrease with the scapula in internal rotation. Knee Surg Sports Traumatol Arthrosc, 2015;23(5):1467-72. DOI: 10.1007/s00167-013-2823-2
  • 9. Moseley HF, Goldie I, The Arterial Pattern of the Rotator Cuff of the Shoulder. J Bone Joint Surg Br, 1963. 45(4):780-9 PMID: 14074332
  • 10. Ko JY, Huang CC, Chen WJ, Chen CE, Chen SH, Wang CJ, Pathogenesis of partial tear of the rotator cuff: a clinical and pathologic study. J Shoulder Elbow Surg, 2006;15(3): 271-8. PMID: 16679225
  • 11. Guntern DV, Pfirrmann CW, Schmid MR, Zanetti M, Binkert CA, Schneeberger AG, Articular cartilage lesions of the glenohumeral joint: diagnostic effectiveness of MR arthrography and prevalence in patients with subacromial impingement syndrome. Radiology, 2003;226(1):165-70. PMID: 12511686
  • 12. Petersson CJ, Degeneration of the gleno-humeral joint: an anatomical study. Acta Orthop Scand, 1983;54(2):277-283. PMID: 6846007
  • 13. Singh HP, Mehta SS, Pandey R, A preoperative scoring system to select patients for arthroscopic subacromial decompression. J Shoulder Elbow Surg, 2014;23(9):1251-6. PMID: 25127909
  • 14. Watson M, Major ruptures of the rotator cuff. The results of surgical repair in 89 patients. J Bone Joint Surg Br, 1985;67(4):618-24 PMID: 4030862
  • 15. Wong MW, Tang YY, Lee SK, Fu BS, Chan BP, Chan CK, Effect of dexamethasone on cultured human tenocytes and its reversibility by platelet-derived growth factor. J Bone Joint Surg Am, 2003;85-A(10): 1914-20 . PMID: 14563798
  • 16. Yıldız V, Aydın A, Kalalı F, Yıldırım ÖS, Topal M, Aydın P, Kronik İmpingement Sendromlu Hastalarda Uygulanan Steroidin Artroskopik Subakromiyal Dekompresyon Sonrasına Klinik Etkisi. Fırat Tıp Dergisi. 2012;17(1): 32-35.
  • 17. Brox JI, Gjengedal E, Uppheim G, Bohmer AS, Brevik JI, Ljunggren AE, Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): a prospective, randomized, controlled study in 125 patients with a 2 1/2-year follow-up. J Shoulder Elbow Surg, 1999;8(2): 102-11. PMID: 10226960
  • 18. Karaman Ö, Karakuş Ö, Kaynak G, Çalışkan G, Saygı B, Artroskopik subakromiyal dekompresyon: 1-4 yıllık sonuçlar. Şişli Etfal Tıp Bülteni, 2012;46(3):136-139.
  • 19. Beard DJ, Rees JL, Cook JA, Rombach I, Cooper C, Merritt N, Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial. Lancet, 2018; 391(10118):329-338 DOI: 10.1016/S0140-6736(17)32457-1
  • 20. Bouchard A, Garret J, Favard L, Charles H, Ollat D, Failed subacromial decompression. Risk factors. Orthopaedics & Traumatology: Surgery & Research, 2014; 100(8): S365-S369 PMID: 25454330
  • 21. Bhattacharyya R, Edwards K, Wallace AW, Does arthroscopic sub-acromial decompression really work for sub-acromial impingement syndrome: a cohort study. BMC musculoskeletal disorders, 2014;15(1):324. PMCID: 4190469
  • 22. Farfaras S, Sernert N, Rostgard Christensen L, Hallström EK, Kartus JT, Subacromial decompression yields a better clinical outcome than therapy alone: a prospective randomized study of patients with a minimum 10-year follow-up. The American journal of sports medicine, 2018. 46(6):1397-1407. PMID: 29543510
  • 23. Lerch S, Elki S, Jaeger M, Berndt T, Arthroskopische subakromiale Dekompression. Operative Orthopädie und Traumatologie, 2016. 28(5):373-391 DOI: 10.1007/s00064-016-0450-z
  • 24. Jaeger M, Berndt T, Rühmann O, Lerch S, Patients with impingement syndrome with and without rotator cuff tears do well 20 years after arthroscopic subacromial decompression. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2016;32(3): 409-415. PMID: 26507160
There are 24 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research Article
Authors

Aziz Atik 0000-0002-2125-6465

Publication Date October 26, 2019
Submission Date May 18, 2019
Acceptance Date July 30, 2019
Published in Issue Year 2019 Volume: 3 Issue: 3

Cite

Vancouver Atik A. The Role of Arthroscopic Decompression in Subacromial Impingement Syndrome. Acta Med. Alanya. 2019;3(3):248-53.

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