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Sub acromial decompression

David J Beard, Jonathan L Rees, Jonathan A Cook, Ines Rombach, Cushla Cooper, Naomi Merritt, Beverly A Shirkey, Jenny L Donovan, Stephen Gwilym, Julian Savulescu, Jane Moser, Alastair Gray, Marcus Jepson, Irene Tracey, Andrew Judge, Karolina Wartolowska, Andrew J Carr
BACKGROUND: Arthroscopic sub-acromial decompression (decompressing the sub-acromial space by removing bone spurs and soft tissue arthroscopically) is a common surgery for subacromial shoulder pain, but its effectiveness is uncertain. We did a study to assess its effectiveness and to investigate the mechanism for surgical decompression. METHODS: We did a multicentre, randomised, pragmatic, parallel group, placebo-controlled, three-group trial at 32 hospitals in the UK with 51 surgeons...
January 27, 2018: Lancet
Stephanie G Dakin, Christopher D Buckley, Mohammad Hussein Al-Mossawi, Robert Hedley, Fernando O Martinez, Kim Wheway, Bridget Watkins, Andrew J Carr
BACKGROUND: Growing evidence supports a key role for inflammation in the onset and progression of tendinopathy. However, the effect of the inflammatory infiltrate on tendon cells is poorly understood. METHODS: We investigated stromal fibroblast activation signatures in tissues and cells from patients with tendinopathy. Diseased tendons were collected from well-phenotyped patient cohorts with supraspinatus tendinopathy before and after sub-acromial decompression treatment...
January 25, 2017: Arthritis Research & Therapy
Rohit Singh, Akshay Malhotra, Gillian Cribb, Paul Cool, Stuart Hay
Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromio-clavicular joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires left from previous surgery can cause similar symptoms. We present a series of four cases mimicking "classical" impingement symptoms/signs in which the causal pathology was identified outside the sub-acromial space...
September 2016: Annals of Medicine and Surgery
Amit Sharad Chandra Bidwai, Ann Birch, David Temperley, Saurabh Odak, Michael J Walton, John F Haines, Ian Trail
BACKGROUND: We report on the medium- to long-term results of a randomized controlled trial (RCT) aiming to determine whether rotator cuff repair confers any advantage over arthroscopic sub-acromial decompression (ASAD) alone in the management of medium-sized rotator cuff tears. METHODS: Ethical approval was sought to follow-up patients previously enrolled in a completed and previously published RCT comparing the outcome of ASAD with mini-open cuff repair for the treatment of rotator cuff tear...
April 2016: Shoulder & Elbow
Laura Rachel Marshall, Alison Edgley
AIM: To consider the pros and cons of focus groups versus interviews for studies interested in examining patient experiences of clinical interventions. The paper looks at the hazards of being a clinician when collecting qualitative data and shares these experiences to provide useful learning for other clinicians embarking on qualitative approaches. BACKGROUND: Sub-acromial decompression surgery (SAD) is the accepted, surgical intervention for shoulder impingement syndrome...
May 2015: Nurse Researcher
S J Snyder, G J Fasulo
Arthroscopic techniques for shoulder arthroscopy have evolved and been refined constantly over the last decade. Significant advances have been made, compared to the first arthroscopic intraarticular examinations on cadavers by Takagi in 1918. Advances in fiberoptics, computer technology, and surgical instrumentation, coupled with innovative ideas and improved operative skills, have opened a new era in the orthopedic evaluation of intraarticular structures and treatment of pathology by the orthopedic surgeon...
October 1993: Surgical Technology International
Rahul Bhattacharyya, Kimberley Edwards, Angus W Wallace
BACKGROUND: Health Economists in Denmark have reported poor outcomes and low and delayed return to work for patients treated for Sub-Acromial Impingement syndrome (SAIS) by Arthroscopic Sub-Acromial Decompression (ASAD). In this setting it is important to evaluate outcomes following this commonly performed operation to justify undertaking it on our patients. The purpose of the study was to evaluate the effectiveness of ASAD for patients with SAIS and correlate clinical outcome with rate of return to work...
September 29, 2014: BMC Musculoskeletal Disorders
Arpit Jariwala, B C Raju Pavan Kumar, David M Coventry
Advanced imaging techniques, improved operative techniques, and instrumentation combined with better patient awareness and expectations have resulted in an exponential increase in upper limb surgical procedures during recent times. Surgical teams expect superior analgesia and regional blocks have matched these expectations quite often resulting in improved patient satisfaction and early rehabilitation to achieve best results. Ultrasound-guided interscalene brachial plexus block (ISB) is commonly used to provide analgesia for procedures involving shoulder girdle...
April 2014: International Journal of Shoulder Surgery
L Urbánek, P Vašek, M Tuček
PURPOSE OF THE STUDY: Our objective is to introduce our simplified, easy-to-use classification of rotator cuff (RC) lesions, describe the frequency of individual findings in a considerably large series of shoulder joints examined by arthroscopy, evaluate the results of the operative management of individual lesion types, and recommend optimal surgical approaches. MATERIAL: Over the course of 10 years (between October 1st, 2000 and December 31st, 2009), 756 arthroscopic operations on the shoulder joint were performed...
2011: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
N P M Jain, L Ogonda, N P Trimmings
INTRODUCTION: Admission following day-case surgery can be problematic for both the patient and the health service. The purpose of this study was to identify any factors predictive of admission following arthroscopic sub-acromial decompression (ASAD) of the shoulder planned as day-case procedures. PATIENTS AND METHODS: A postal questionnaire provided data for 27 patients undergoing ASAD as a day-case procedure between June 2002 and June 2004. RESULTS: Eighteen (66...
January 2008: Annals of the Royal College of Surgeons of England
Toby Baring, Roger Emery, Peter Reilly
Disease of the rotator cuff is common. It is responsible for a high proportion of patients with shoulder pain presenting to general practice, causing work absenteeism and claims for sickness benefits. Rotator cuff disease (RCD) can often be managed in primary health care services, although some cases may require secondary referral. Both extrinsic and intrinsic factors to the cuff tendon are thought to be involved in the pathogenesis leading on to a spectrum of conditions ranging from sub-acromial bursitis to mechanical failure of the cuff tendon itself...
April 2007: Best Practice & Research. Clinical Rheumatology
H Thomazeau, P Gleyze, A Frank, C Lévigne, G Walch, P Devallet
PURPOSE OF THE STUDY: The purpose of this study was to assess clinical and radiological course of full-thickness rotator cuff tears treated by arthroscopic debridement and to discuss surgical indications according to patient demands and anatomical lesions. MATERIAL AND METHODS: This retrospective and multicentric study included patients with a minimal 3 years follow-up. The coronal extent of the supraspinatus tear was described as distal, intermediate or retracted...
April 2000: Revue de Chirurgie Orthopédique et Réparatrice de L'appareil Moteur
J C Le Huec, F Liquois, T Schaeverbecke, B Zipoli, D Chauveaux, A Le Rebeller
PURPOSE OF THE STUDY: We report a series of 14 patients with a massive rotator cuff tear operated on with a deltoid flap according to Augereau's technique. The aim of this study was to evaluate the benefits of this technique using Constant's scoring system. The follow up is 40 months. MATERIAL AND METHOD: 14 patients, mean age 59 years, with a total rotator cuff tear type III according to Gerber's classification were included. There was 13 total ruptures of the supra and infra spinatus tendon and one infraspinatus and subscapularis lesion...
1996: Revue de Chirurgie Orthopédique et Réparatrice de L'appareil Moteur
A Hartig, M Rojczyk
Between January 1989 and December 1991 614 arthroscopic subacromial decompressions were performed for impingement syndromes. The first 100 cases represented our learning curve. The first 74 of the remaining 514 cases were available for evaluation and form the basis of the results presented here. Twenty (27.02%) patients were rated stage II in Neer's classification and 54 (72.98%) were rated stage III, 33 (44.59%) of them with a small full-thickness tear (less than 1 cm) and 21 (28.37%) with larger defects. Patients were evaluated pre- and postoperatively utilizing the ULCA shoulder score...
February 1993: Der Unfallchirurg
M Jaffe, A Frank, P Beaufils
PURPOSE OF THE STUDY: The authors have conducted a study to evaluate the possible efficacy of endoscopic decompression without repair in the treatment of rotator cuff tears. MATERIAL AND METHOD: We report 42 cases of endoscopic acromioplasty realized for full-thickness rotator cuff tears. Mean follow-up was 28.8 months. The principal presenting symptom was pain, with a mean duration of 29 months. Antero-external acromioplasty was realized by endoscopy using motorized drill bits, with sectioning or resecting the acromio-coracoid ligament...
1994: Revue de Chirurgie Orthopédique et Réparatrice de L'appareil Moteur
R Biedert, A Kentsch
Degenerative lesions of the subacromial structures can cause chronic anterior pain and disability of the shoulder. They are most frequently found in patients whose arms are repeatedly exposed to force while raised above head level, e.g. during tennis, volleyball or swimming. This is often due to impingement of the supraspinatus tendon, the subacromial bursa or the biceps tendon against the anterior edge and lower surface of the anterior third of the acromion, the coracoacromial ligament and, in some cases, the acromioclavicular joint...
October 1989: Der Unfallchirurg
W Lack, R Windhager, D Uyka
We describe the theoretical principles of a new kind of decompression of subacromial impingement syndrome by means of a wedge osteotomy at the transition between acromion and spine of the scapula. The operation on cadaver bone and the simulation of acromion movement in a computer model demonstrate an increase of subacromial space more than 1 cm after wedge excision with cranial base of 5 mm and ventral base of 3 mm. After the excision of an anterior based wedge the resection of the coracoacromial ligament is not necessary...
July 1991: Zeitschrift Für Orthopädie und Ihre Grenzgebiete
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