Arthroscopic treatment of painful snapping of the scapula by using a new superior portal

Abstract

Purpose: To evaluate the results of arthroscopic resection of the superomedial corner of the scapula, using a new superior portal, in patients with a snapping scapula problem. Type of Study: Case series. Methods: Ten patients with painful snapping of the scapula were treated arthroscopically using standard portals as well as a recently developed superior arthroscopic portal. There were 4 women and 6 men with a mean age of 26.9 years (range, 16 to 40 years). All patients were right-handed with a right side operation in 8 cases. There was a history of significant shoulder trauma in 6 patients. All patients had normal preoperative computed tomography scans and radiographs. The average duration of symptoms before surgery was 53.2 months (range, 12 to 154 months). At follow-up, the results were scored using the UCLA system. Results: All patients were followed-up at an average of 11.5 months (range, 3 to 23 months). There were no intraoperative or postoperative complications and, in particular, no neurologic lesions resulting from the introduction of arthroscopic instruments. The scapulothoracic crepitus resolved in 2 patients and decreased in 8 patients. There was reduction of pain in all cases, with a mean postoperative visual analog pain score of 2.6. Nine patients were able to return to their preoperative work and 6 could return to their previous sports activity. According to the UCLA scores, the results were 4 excellent, 5 good, and 1 fair. All patients reported that the procedure was worthwhile. Conclusions: Arthroscopic surgery is beneficial for patients with painful snapping of the scapula. The new superior portal is safe and has made the operation easier to perform.