Arthroscopic Scapulothoracic Bursectomy with and without Superomedial Angle Scapuloplasty: A Comparison of Patient-Reported Outcomes.

Abstract

Operative treatment of scapulothoracic bursitis most commonly comprises arthroscopic scapulothoracic bursectomy with or without partial superomedial angle scapuloplasty. There is currently no consensus regarding if or when scapuloplasty should be performed. Prior studies are limited to small case series and optimal surgical indications are not yet established. The purposes of this study are to 1) retrospectively review patient reported outcomes of arthroscopic treatment of scapulothoracic bursitis and, 2) compare outcomes between scapulothoracic bursectomy alone and bursectomy with scapuloplasty. The authors hypothesized that bursectomy with scapuloplasty would provide superior pain relief and functional improvement. All cases of scapulothoracic débridement with or without scapuloplasty completed at a single academic center from 2007 through 2020 were reviewed. Patient demographics, symptomatology, physical exam findings, and corticosteroid injection response data were collected from the electronic medical record. Visual analog scale (VAS) pain, American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST), and SANE scores were collected. Comparisons between bursectomy alone and bursectomy with scapuloplasty groups were made using Student's t-test for continuous variables and Fisher's exact test for categorical variables. Thirty patients underwent scapulothoracic bursectomy alone, and 38 patients underwent bursectomy with scapuloplasty. Final follow-up data was completed for 56 of 68 (82%) cases. Final postoperative VAS pain scores (3.4±2.2 vs. 2.8±2.2 (p=0.351)), ASES scores (75.8±17.7 vs. 76.5±22.5 (p=0.895)), and SST scores (8.8±2.3 vs. 9.5±2.8 (p=0.340)) were similar between the bursectomy only and bursectomy with scapuloplasty groups, respectively. Both arthroscopic scapulothoracic bursectomy and bursectomy with scapuloplasty are effective treatments for scapulothoracic bursitis. Operative time is shorter without scapuloplasty. In this retrospective series, these procedures have similar outcomes regarding shoulder function, pain, surgical complications, and rates of subsequent shoulder surgery. Further studies with a focus in 3D scapular morphology may help optimize patient selection for each of these procedures.