RESEARCH ARTICLE


Outcome of Scapulothoracic Arthroscopy for Painful Snapping Scapula



Saif Ul Islam*, Muhammad Naghman Choudhry, Sobia Akbar, Mohammad Waseem
Macclesfield District General Hospital, Cheshire, United Kingdom


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© 2017 Ul Islam et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Macclesfield General Hospital, Victoria Road, Macclesfield, Cheshire, SK10 3BL, United Kingdom, Tel: 00441625661315; E-mail: dr_saifulislam@hotmail.com


Abstract

Introduction:

Patients with scapulothoracic syndrome present with pain in the scapulothoracic area aggravated by overhead and repetitive shoulder movements. The aim of our study was to assess the outcome of scapulothoracic arthroscopic treatment in patients with painful snapping scapula in our institution.

Methods:

Fourteen patients underwent scapulothoracic arthroscopic treatment for painful snapping scapula. Pre-operatively, all these patients had a trial of conservative treatment modalities for at least 6 months.

Two portals along the medial border of scapula were used for arthroscopy and instrumentation. In three cases a superior portal was also used. The arm was placed in the “chicken wing” position so that the scapula lifted up from the chest wall. Outcome was assessed using pre and postoperative pain visual analogue score and Oxford Shoulder Score.

Results:

Of the fourteen patients included in our study, ten were female and four were male patients. Mean age at the time of surgery was 27.6 years. Mean follow up was 35.7 months. Pain visual analogue score improved significantly from a mean of 8.8 preoperatively to 2.5 postoperatively (P value 0.00002). There was also a significant improvement in Oxford Shoulder Score from a mean of 10.8 to 40.9 (P= 0.00001). Mean crepitus score significantly decreased from 2.6 to 0.21 (p < 0.00001). Crepitus completely resolved in eleven patients. In three there was residual palpable crepitus but they had good pain relief.

Conclusion:

Arthroscopic scapulothoracic treatment provides significant pain relief and functional improvement for painful snapping scapula symptoms not responding to non-surgical treatment modalities.

Keywords: Scapulothoracic syndrome, Scapulothoracic arthroscopy, Bursectomy, Snapping, Scapula, Thoracic.