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Kim DH, Sohn HJ, Kim JH, Cho CH. Clinical Outcomes Following Arthroscopic Decompression and Repair versus Repair Alone in Patients with a Concomitant Spinoglenoid Cyst and SLAP Lesion: A Systematic Review. Diagnostics (Basel) 2023; 13:2364. [PMID: 37510107 PMCID: PMC10378101 DOI: 10.3390/diagnostics13142364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Patients with a superior-labrum-from-anterior-to-posterior (SLAP) tear associated with a spinoglenoid ganglion cyst have undergone various procedures. The purpose of this study is to evaluate clinical outcomes following arthroscopic treatment in patients with a concomitant spinoglenoid ganglion cyst and SLAP lesion. (2) Methods: This study followed PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, utilizing the PubMed, EMBASE, Cochrane Library, and Scopus databases. The keywords included shoulder, SLAP, labral tear, spinoglenoid notch, paralabral cyst, arthroscopy, and treatment. (3) Results: A total of 14 articles (206 patients) were included. Repair alone was administered in 114 patients (Group R), and 92 patients underwent additional cyst decompression (Group RD). Both groups showed excellent and similar clinical scores. The rate of the complete resorption of the cyst was 95.5% in Group RD, and 92.2% in Group R. The complication rate was 3.5% in Group RD, and 11.4% in Group R. The reoperation rate was 0% in Group RD, and 5.3% in Group R. (4) Conclusion: Reliable clinical outcomes without serious complications were obtained from the use of both procedures. The decompression of the cyst is a safe method that will alleviate pressure on the suprascapular nerve.
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Affiliation(s)
- Du-Han Kim
- Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Hyuk-Joon Sohn
- Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Ji-Hoon Kim
- Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Chul-Hyun Cho
- Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
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2
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Takayama K, Ito H. An anatomical study for the location of suprascapular and spinoglenoid notches using three-dimensional computed tomography images of scapula. JSES Int 2022; 6:669-674. [PMID: 35813135 PMCID: PMC9264012 DOI: 10.1016/j.jseint.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The optimal position for creating portals for arthroscopic suprascapular nerve decompression has not been sufficiently verified. Therefore, this study aimed to investigate the anatomical characteristics of the scapula for optimal portal creation using 3-dimensional computed tomography images. The posterolateral corner of the acromion was designated as the starting point for measurements because there is no secondary ossification center present. Methods This study included 223 patients (females, 129; males, 94) who underwent computed tomography of the shoulder joint. Three-dimensional images of the scapula were created, and the distance from the posterolateral corner of the acromion to the suprascapular and spinoglenoid notches was measured. Additionally, the correlation coefficient with height and the differences between the female and male groups were investigated. Results The distances from the posterolateral corner of the acromion to the suprascapular and spinoglenoid notches were 42.9 ± 4.6 and 31.5 ± 3.6 mm, respectively, and their correlation coefficients with height were 0.12 and 0.067, respectively. There was no significant difference in the distance from the posterolateral corner of the acromion to the suprascapular (42.5 ± 4.1 vs. 43.9 ± 5.1 mm, P = .098) and to the spinoglenoid (31.4 ± 3.3 mm vs. 32.0 ± 3.9 mm, P = .12) notches between the female and male groups. Conclusion Regardless of height and sex, the distances from the posterolateral corner of the acromion to the suprascapular and spinoglenoid notches were approximately 43 and 32 mm, respectively. Therefore, creating portals at these locations may be effective for arthroscopic suprascapular nerve decompression.
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Affiliation(s)
- Kazumasa Takayama
- Corresponding author: Kazumasa Takayama, MD, 1-1-1 Miwa, Kurashiki, Okayama 7108602, Japan.
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Nolte PC, Woolson TE, Elrick BP, Tross AK, Horan MP, Godin JA, Millett PJ. Clinical Outcomes of Arthroscopic Suprascapular Nerve Decompression for Suprascapular Neuropathy. Arthroscopy 2021; 37:499-507. [PMID: 33091550 DOI: 10.1016/j.arthro.2020.10.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/06/2020] [Accepted: 10/11/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To report clinical outcomes following arthroscopic suprascapular nerve (SSN) decompression for suprascapular neuropathy at the suprascapular and/or spinoglenoid notch in the absence of major concomitant pathology. METHODS We retrospectively reviewed prospectively collected data of 19 patients who underwent SSN release at the suprascapular and/or spinoglenoid notch between April 2006 and August 2017 with ≥2 years of follow-up. Patients who underwent concomitant rotator cuff or labral repairs or had severe osteoarthritis were excluded. Pre- and postoperative strength and patient-reported outcomes were collected, including the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numerical Evaluation (SANE), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), 12-item Short Form (SF-12), and satisfaction. Complications and revisions were recorded. RESULTS At a mean final follow-up of 4.8 years, pre- to postoperative ASES (64.9 ± 18.7 versus 83.5 ± 23.1; P = .018), QuickDASH (28.7 ± 17.2 versus 12.7 ± 17.1; P = .028), SANE (64.3 ± 16.4 versus 80.8 ± 22.3; P = .034), and SF-12 PCS (41.1 ± 10.8 versus 52.3 ± 5.8; P = .007) scores all significantly improved. Median strength for external rotation improved significantly (4 [range 2 to 5] versus 5 [range 3 to 5]; P = .014). There was no statistically significant improvement in median strength for abduction (4 [range 3 to 5] versus 5 [5]; P = .059). Median postoperative satisfaction was 9 (range 1 to 10), with 8 patients (50%) rating satisfaction ≥9. No complications were observed, and no patients went on to revision surgery. CONCLUSION Arthroscopic SSN decompression for suprascapular neuropathy at the suprascapular and/or spinoglenoid notch in the absence of major concomitant glenohumeral pathology results in good functional outcomes with significant improvements from before to after surgery. LEVEL OF EVIDENCE IV, therapeutic case series.
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Affiliation(s)
- Philip C Nolte
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; BG Trauma Center Ludwigshafen at the University of Heidelberg, Clinic for Trauma and Orthopaedic Surgery, Ludwigshafen, Germany
| | | | - Bryant P Elrick
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | - Anna-Katharina Tross
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Heidelberg University Hospital, Clinic for Orthopedics and Trauma Surgery, Heidelberg, Germany
| | - Marilee P Horan
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
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LiBrizzi CL, Rojas JL, Bontrager NC, Srikumaran U, McFarland EG. Suprascapular nerve entrapment in young kayaker: a case report. PHYSICIAN SPORTSMED 2020; 48:236-240. [PMID: 31469970 DOI: 10.1080/00913847.2019.1662273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Kayaking has become one of the most popular paddle sports throughout the world. The shoulder is the most commonly injured area of the body among kayaking participants as a result of acute traumatic events and chronic overuse injuries. Therefore, kayaking participants may often seek advice for shoulder problems and there is a scarcity of studies regarding shoulder injuries in this population. In this case report, we present a young male recreational whitewater kayaker with a severe suprascapular nerve (SSN) entrapment who presented with shoulder pain and inability to perform his sport. He was initially evaluated elsewhere and was treated with nonsteroidal anti-inflammatory medications and physical therapy for presumptive diagnosis of subacromial impingement. After 5 months of failed non-operative treatment, the patient sought a second opinion with our group. SSN entrapment diagnosis was confirmed by a thorough careful physical examination, magnetic resonance imaging and electrodiagnostic study. Given the failure of non-operative treatment, the patient was treated with arthroscopic SSN decompression and successfully returned to kayaking without symptoms. While SSN entrapment has been reported in a variety of sports, especially those involving overhead movements, this is the first case report of SSN entrapment reported which impaired participation in kayaking. This case report supports the consideration of SSN entrapment in the differential diagnosis of painful shoulder among kayaking participants and highlights the importance of undressing the patient and examining the posterior shoulder for atrophy, winging or deformity.
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Affiliation(s)
- Christa L LiBrizzi
- The Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Jorge L Rojas
- The Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Nicholas C Bontrager
- The Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Uma Srikumaran
- The Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Edward G McFarland
- The Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
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Promsang T, Kongrukgreatiyos K, Kuptniratsaikul S. Arthroscopic Decompression of Spinoglenoid Notch Cyst and SLAP Repair Through a Single Working Portal. Arthrosc Tech 2018; 7:e963-e967. [PMID: 30258779 PMCID: PMC6153417 DOI: 10.1016/j.eats.2018.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/25/2018] [Indexed: 02/03/2023] Open
Abstract
A SLAP lesion can be found with a concomitant spinoglenoid notch cyst. The cyst can cause suprascapular nerve compression, resulting in shoulder pain and weakness of external rotation. Their management varies from conservative treatment to operative treatment. Cyst decompression through the labral tear is our preferred treatment. Previous studies demonstrated a good result after arthroscopic decompression of the cyst through the labral tear combined with SLAP repair. Many surgeons usually use 3 portals to perform this procedure. However, we prefer to use only 2 portals, 1 anterior viewing portal and 1 posterior working portal. This strategy is more time and cost efficient. The patient is positioned in lateral decubitus. The SLAP lesion is demonstrated by using a probe. Tissue elevator is inserted into the labral lesion to penetrate into the cyst wall. A soft anchor is placed. A birdbeak suture passer penetrates the posterior labrum. Then knot tying is done. The advantages of this single working portal technique are short operative time, a decreased risk of iatrogenic rotator cuff injury from accessory anterolateral portal or posterior labral injury from posterolateral portal, and avoiding unnecessary superior capsule incision for cyst exposure.
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Affiliation(s)
- Trai Promsang
- Department of Orthopaedics, Sikarin Hospital, Bangkok, Thailand
- Address correspondence to Trai Promsang, M.D., M.S., Sikarin Hospital, Department of Orthopaedics, 4/29 Moo 10, Srinakarin road Bang-Na sub-district, Bangkok 10260.
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6
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Schroeder AJ, Bedeir YH, Schumaier AP, Desai VS, Grawe BM. Arthroscopic Management of SLAP Lesions With Concomitant Spinoglenoid Notch Ganglion Cysts: A Systematic Review Comparing Repair Alone to Repair With Decompression. Arthroscopy 2018; 34:2247-2253. [PMID: 29501216 DOI: 10.1016/j.arthro.2018.01.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine if cyst management is necessary in the setting of SLAP lesions with concomitant paralabral ganglion cysts. METHODS We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, including all studies that met inclusion criteria from January 1975 to July 2015. We included patients with a SLAP II-VII lesion and a concomitant paralabral ganglion cyst who underwent arthroscopic labral repair with or without cyst decompression. Patients with follow-up of less than 3 months, a SLAP I lesion, or who underwent concomitant cuff repair were excluded. The Methodological Index for Non-randomized Studies (MINORS) scoring system was used to quantify the potential bias in each study. Outcome measures reported were provided in a table format and a subjective analysis was performed. RESULTS Nineteen studies were included yielding a total of 160 patients: 66 patients treated with repair alone [R] and 94 patients with additional cyst decompression or excision [R+D]. The VAS, Rowe, and Constant scores were excellent and similar in both groups. The mean VAS was 0.6 in [R] and ranged between 0 and 2 in [R+D] (0.5, 0, 2, 0.2). The mean Rowe scores were 94 and 98 in [R] and 95 in [R+D]. The mean Constant scores were 97 in [R] and ranged between 87 and 98 in [R+D] (98, 87, 92, 94). In total, 5 of 90 patients were unable to return to work and 2 of 45 were unable to return to sport. All 15 patients who had follow-up electromyographies displayed resolution, and in the 115 patients with follow-up MRIs, 12 did not have complete resolution of the cyst. CONCLUSIONS Despite the lack of high-quality evidence, the studies subjectively analyzed in this review suggest that both groups have excellent results. The results do not show any advantages from performing decompression. LEVEL OF EVIDENCE Level IV, systematic review of Level II and Level IV studies.
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Affiliation(s)
- Amanda J Schroeder
- Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A
| | - Yehia H Bedeir
- Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A..
| | - Adam P Schumaier
- Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A
| | - Vishal S Desai
- Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A
| | - Brian M Grawe
- Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A
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Schrøder CP, Lundgreen K, Kvakestad R. Paralabral cysts of the shoulder treated with isolated labral repair: effect on pain and radiologic findings. J Shoulder Elbow Surg 2018; 27:1283-1289. [PMID: 29449084 DOI: 10.1016/j.jse.2017.12.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/02/2017] [Accepted: 12/12/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Paralabral cysts emanating from posterosuperior labral tears may compress the suprascapular nerve and induce neuropathy. This study prospectively assessed patients with labral tears and symptomatic paralabral cysts treated with isolated labral repair. Pain relief, time to cyst resolution, reversibility of muscular edema, atrophy, fatty infiltration, and bone erosion were evaluated. METHODS Forty-seven patients with symptomatic posterosuperior paralabral cysts were treated with isolated labral repair. Magnetic resonance imaging (MRI) was repeated 6 and 12 weeks postoperatively or until cyst resolution. In a subgroup of 15 patients, MRI was performed the day before the operation, the first postoperative day, and at 2 weeks. RESULTS Median cyst size was 6.8 cm3 (range, 2.1-88.9; standard deviation [SD], 18.3 cm3). Preoperatively, 20 patients (43%) presented clinical muscle atrophy and radiologic edema on MRI, 8 had fatty infiltration, and 3 presented bony scapular erosion caused by cyst compression. Median time to cyst resolution and regression of muscular edema was 11 weeks (range, 3-20; SD, 8.8 weeks) and 14 weeks (range, 3-52; SD 10.6 weeks), respectively. Preoperative fatty infiltration grade I and II of the supraspinatus and infraspinatus muscles was reduced in two patients. Bony erosions remodeled after cyst resolution. Mean pain ratings (1-10 scale) improved from 7.7 (SD, 1.8) to 1.3 (SD, 1.3; 95% confidence interval of difference, 5.5-6.8; P < .001). CONCLUSION Labral repair leads to significant pain relief with cyst resolution within 2 to 3 months in most patients. Secondary muscle pathology (ie, edema, atrophy and fatty infiltration) may be partially or completely reversed. Bony erosion caused by cyst compression may be remodeled after cyst resolution.
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Affiliation(s)
- Cecilie P Schrøder
- Department of Orthopedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway.
| | - Kirsten Lundgreen
- Department of Orthopedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Rune Kvakestad
- Department of Radiology, Lovisenberg Diaconal Hospital, Oslo, Norway
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Momaya AM, Kwapisz A, Choate WS, Kissenberth MJ, Tolan SJ, Lonergan KT, Hawkins RJ, Tokish JM. Clinical outcomes of suprascapular nerve decompression: a systematic review. J Shoulder Elbow Surg 2018; 27:172-180. [PMID: 29221575 DOI: 10.1016/j.jse.2017.09.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/16/2017] [Accepted: 09/20/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Suprascapular neuropathy is an uncommon clinical diagnosis. Although there have been a number of case series reporting on this pathologic process, to date there has been no systematic review of these studies. This study aimed to synthesize the literature on suprascapular neuropathy with regard to clinical outcomes. The secondary objective was to detail the diagnosis and treatment of suprascapular neuropathy and any associated complications. METHODS A systematic review was performed to identify studies that reported the results or clinical outcomes of suprascapular nerve decompression. The searches were performed using MEDLINE through PubMed and Cochrane Database of Systematic Reviews. RESULTS Twenty-one studies comprising 275 patients and 276 shoulders met inclusion criteria. The mean age was 41.9 years, and mean follow-up was 32.5 months. The most common symptom was deep, posterior shoulder pain (97.8%), with a mean duration of symptoms before decompression of 19.0 months; 94% of patients underwent electrodiagnostic testing before decompression, and 85% of patients had results consistent with suprascapular neuropathy. The most common outcome reported was the visual analog scale score, followed by the Constant-Murley score. The mean postoperative Constant-Murley score obtained was 89% of ideal maximum. Ninety-two percent of athletes were able to return to sport. Only 2 (0.74%) complications were reported in the included studies. CONCLUSIONS Surgical decompression in the setting of suprascapular neuropathy leads to satisfactory outcomes as evidenced by the patient-reported outcomes and return to sport rate. Furthermore, the rate of complications appears to be low.
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Affiliation(s)
- Amit M Momaya
- Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA
| | - Adam Kwapisz
- Hawkins Foundation, Greenville, SC, USA; Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Łódź, Poland
| | - W Stephen Choate
- Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA
| | - Michael J Kissenberth
- Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA
| | - Stefan J Tolan
- Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA
| | - Keith T Lonergan
- Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA
| | - Richard J Hawkins
- Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA
| | - John M Tokish
- Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA; Mayo Clinic Arizona, Phoenix, AZ, USA.
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Memon M, Kay J, Ginsberg L, Simunovic N, Bak K, Lapner P, Ayeni OR. Arthroscopic management of suprascapular neuropathy of the shoulder improves pain and functional outcomes with minimal complication rates. Knee Surg Sports Traumatol Arthrosc 2018; 26:240-266. [PMID: 28879607 DOI: 10.1007/s00167-017-4694-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/21/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE The purpose of this study was to systematically assess the arthroscopic management of suprascapular neuropathy, including the aetiology, surgical decision-making, clinical outcomes, and complications associated with the procedure. METHODS Three databases [PubMed, Ovid (Medline), and Embase] were searched. Systematic literature screening and data abstraction was performed in duplicate to present a review of studies reporting on arthroscopic management of suprascapular neuropathy. The quality of the included studies was assessed using level of evidence and the MINORS (Methodological Index for Nonrandomized Studies) checklist. RESULTS In total, 40 studies (17 case reports, 20 case series, 2 retrospective comparative studies, and 1 prospective comparative study) were identified, including 259 patients (261 shoulders) treated arthroscopically for suprascapular neuropathy. The most common aetiology of suprascapular neuropathy was suprascapular nerve compression by a cyst at the spinoglenoid notch (42%), and the decision to pursue arthroscopic surgery was most commonly based on the results of clinical findings and investigations (47%). Overall, 97% of patients reported significant improvement in or complete resolution of their pre-operative symptoms (including pain, strength, and subjective function of the shoulder) over a mean follow-up period of 23.7 months. Further, there was a low overall complication rate (4%) associated with the arthroscopic procedures. CONCLUSION While most studies evaluating arthroscopic management of suprascapular neuropathy are uncontrolled studies with lower levels of evidence, results indicate that such management provides patients with significant improvements in pain, strength, and subjective function of the shoulder, and has a low incidence of complications. Patients managed arthroscopically for suprascapular neuropathy may expect significant improvements in pain, strength, and subjective function of the shoulder. LEVEL OF EVIDENCE Level IV, systematic review of level II to IV studies.
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Affiliation(s)
- M Memon
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - J Kay
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - L Ginsberg
- Department of Life Sciences, McMaster University, Hamilton, ON, Canada
| | - N Simunovic
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - K Bak
- Sports Clinic, Aleris-Hamlet Parken, Oester Alle 42, 2nd Floor, Copenhagen, Denmark
| | - P Lapner
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - O R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, McMaster University, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
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Hölscher T, Weber T, Lazarev I, Englert C, Dendorfer S. Influence of rotator cuff tears on glenohumeral stability during abduction tasks. J Orthop Res 2016; 34:1628-35. [PMID: 26756861 DOI: 10.1002/jor.23161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 01/04/2016] [Indexed: 02/04/2023]
Abstract
One of the main goals in reconstructing rotator cuff tears is the restoration of glenohumeral joint stability, which is subsequently of utmost importance in order to prevent degenerative damage such as superior labral anterior posterior (SLAP) lesion, arthrosis, and malfunction. The goal of the current study was to facilitate musculoskeletal models in order to estimate glenohumeral instability introduced by muscle weakness due to cuff lesions. Inverse dynamics simulations were used to compute joint reaction forces for several static abduction tasks with different muscle weakness. Results were compared with the existing literature in order to ensure the model validity. Further arm positions taken from activities of daily living, requiring the rotator cuff muscles were modeled and their contribution to joint kinetics computed. Weakness of the superior rotator cuff muscles (supraspinatus; infraspinatus) leads to a deviation of the joint reaction force to the cranial dorsal rim of the glenoid. Massive rotator cuff defects showed higher potential for glenohumeral instability in contrast to single muscle ruptures. The teres minor muscle seems to substitute lost joint torque during several simulated muscle tears to maintain joint stability. Joint instability increases with cuff tear size. Weakness of the upper part of the rotator cuff leads to a joint reaction force closer to the upper glenoid rim. This indicates the comorbidity of cuff tears with SLAP lesions. The teres minor is crucial for maintaining joint stability in case of massive cuff defects and should be uprated in clinical decision-making. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1628-1635, 2016.
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Affiliation(s)
- Thomas Hölscher
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany
| | - Tim Weber
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany
| | - Igor Lazarev
- Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
| | | | - Sebastian Dendorfer
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany.,Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
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