Die operative Therapie des anterosuperioren Schulterimpingements

Translated title of the contribution: Surgical treatment of anterosuperior impingement of the shoulder

J. Pogorzelski, K. Beitzel, A. B. Imhoff, P. Millett, S. Braun

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: Therapy of intraarticular lesions and elimination of structural risk factors for those suffering from clinical manifest anterosuperiorer impingement (ASI) of the shoulder. This includes as a maximum version the arthroscopic repair of supraspinatus (SST) and subscapularis tendon (SCT) tears with subsequent subpectoral tenodesis of the long head of the biceps tendon (LBT) and arthroscopic coracoplasty. Indications: Clinical manifest anterosuperiorer impingement of the shoulder with anterior shoulder pain, failed conservative treatment and clear intraarticular damage in radiological imaging. This involves in detail lesions of the SST, SCT and damage to the LBT. Contraindications: Lack of structural intraarticular lesions or massive osteoarthritis. Persistent dysfunction of active and passive glenohumeral and scapulathoracal motion, due to neurologic deficits or stiff shoulder. A hypertrophic or deformed healed coracoid process is seen as a structural risk factor for suffering from ASI and should be addressed surgically when causing impingement. Surgical technique: Arthroscopic tenotomy of the LBT with subsequent repair of the SST and SCT. Arthroscopic coracoplasty if indicated and subpectoral tenodesis of the long head of the biceps. Postoperative management: No biceps activity and intermittent immobilization in sling for 6 weeks. Limitation of abduction, flexion and external rotation for 6 weeks depending on rotator cuff tendon repair. Start of sport-specific training after 3 months, over-head sports 6 months postoperatively. Results: The arthroscopic repair of anterosuperior rotator cuff tears provides reliable results for improvement in function, decreases in pain and improvement in shoulder scores. The overall rate of adverse events is low.

Translated title of the contributionSurgical treatment of anterosuperior impingement of the shoulder
Original languageGerman
Pages (from-to)418-429
Number of pages12
JournalOperative Orthopadie und Traumatologie
Volume28
Issue number6
DOIs
StatePublished - 1 Dec 2016
Externally publishedYes

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