Zeng Gerald Joseph, Puah Ken Lee, Hao Ying, Lie Denny Tjiauw Tjoen
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
SingHealth Health Services Research Centre, Singapore.
Orthop J Sports Med. 2021 Apr 26;9(4):2325967121998273. doi: 10.1177/2325967121998273. eCollection 2021 Apr.
Scapulothoracic bursitis is a significant clinical condition that limits day-to-day function. Arthroscopic scapular debridement and resection have provided satisfactory outcomes; however, techniques, approaches, and recommendations remain varied. Novel bony parameters have also gained increasing interest owing to their value in preoperative planning.
To assess midterm clinical outcomes after the arthroscopic management of scapulothoracic bursitis and to identify and measure novel bony parameters on preoperative magnetic resonance imaging.
Case series; Level of evidence, 4.
A total of 8 patients underwent arthroscopic scapular debridement and bursectomy; 5 of the 8 patients underwent additional medial scapulectomy. There were 5 male (62.5%) and 3 female (37.5%) patients with a mean age of 30.1 ± 12.3 years (range, 19-58 years). Inclusion criteria for surgery were patients with symptomatic scapulothoracic bursitis for whom extensive nonoperative modalities had been utilized for at least 6 months but failed. Outcome measures included the Oxford Shoulder Score (OSS), University of California Los Angeles (UCLA) shoulder rating scale, Constant Shoulder Score (CSS), and visual analog scale (VAS) for pain. The bony parameters included scapular shape, anterior offset, costomedial angle, and medial scapular corpus angle (MSCA).
The follow-up duration was at least 2 years for all patients (mean follow-up, 25.0 ± 4.1 months [range, 24-35 months]). The majority of patients had a concave-shaped scapula (62.5%). The mean anterior offset was 24.3 ± 3.4 mm, and the mean costomedial angle was 132.3° ± 9.6°. Half the patients had a positive MSCA, while the other half had a negative MSCA. A statistically significant improvement was observed in the OSS, UCLA, CSS, and VAS scores from preoperatively to 2-year follow-up ( < .001 for all). No complications were observed.
Arthroscopic scapular debridement and resection provided satisfactory midterm clinical outcomes for the treatment of scapulothoracic bursitis.
肩胛胸壁滑囊炎是一种严重的临床病症,会限制日常功能。关节镜下肩胛清创和切除术已取得了令人满意的效果;然而,技术、入路及建议仍存在差异。新型骨参数因其在术前规划中的价值也日益受到关注。
评估关节镜治疗肩胛胸壁滑囊炎的中期临床疗效,并在术前磁共振成像上识别和测量新型骨参数。
病例系列;证据等级,4级。
共有8例患者接受了关节镜下肩胛清创和滑囊切除术;8例患者中有5例还接受了额外的肩胛内侧切除术。有5名男性(62.5%)和3名女性(37.5%)患者,平均年龄为30.1±12.3岁(范围19 - 58岁)。手术纳入标准为患有症状性肩胛胸壁滑囊炎且已采用广泛的非手术方法治疗至少6个月但失败的患者。疗效指标包括牛津肩部评分(OSS)、加州大学洛杉矶分校(UCLA)肩部评分量表、常数肩部评分(CSS)以及疼痛视觉模拟量表(VAS)。骨参数包括肩胛形状、前偏移、肋内侧角和肩胛内侧体角(MSCA)。
所有患者的随访时间至少为2年(平均随访时间,25.0±4.1个月[范围24 - 35个月])。大多数患者的肩胛呈凹形(62.5%)。平均前偏移为24.3±3.4毫米,平均肋内侧角为132.3°±9.6°。一半患者的MSCA为阳性,另一半为阴性。从术前到2年随访时,OSS、UCLA、CSS和VAS评分均有统计学意义的改善(所有P <.001)。未观察到并发症。
关节镜下肩胛清创和切除术为治疗肩胛胸壁滑囊炎提供了令人满意的中期临床疗效。