Outcomes After Arthroscopic Scapulothoracic Bursectomy and Partial Superomedial Angle Scapulectomy

Abstract

Arthroscopic scapulothoracic bursectomy with partial superomedial angle scapulectomy has been described as a surgical treatment for persistent scapulothoracic bursitis with varying results. The purpose of this study was to evaluate patients after arthroscopic scapulothoracic bursectomy and partial scapulectomy utilizing validated functional outcome instruments. 15 patients underwent arthroscopic scapulothoracic bursectomy and partial superomedial angle scapulectomy. 13 of 15 were available for review at an average of 27 months follow-up (range, 13 to 65 months). Patients were evaluated preoperatively and postoperatively with a history, physical exam evaluating medial scapula border tenderness and crepitus, a visual analog scale pain (VAS pain) scale and the Simple Shoulder Test (SST). Postoperatively patients were also evaluated with a yes/no question on satisfaction and the American Shoulder and Elbow Surgeons (ASES) score. SST and VAS pain scores improved by 2.6 (p=0.03) and 4.3 (p<0.001) points. 92% (12 of 13) of patients were satisfied and 92% (12 of 13) stated they would have the surgical procedure performed again. The average ASES postoperative score was 80.1 (range, 38 to 100). The two clinical failures (ASES scores under 50) had either a Workers Compensation claim with persistent medial border tenderness or ongoing rotator cuff disease. The single unsatisfied patient had persistent medial border tenderness and crepitus. Arthroscopic scapulothoracic bursectomy with partial superomedial angle scapulectomy is a reasonable treatment option for scapulothoracic bursitis. Improvements in pain and functional outcome scores are predictable. Poorer outcomes may be observed in patients with ongoing Workers Compensation claims or with concurrent syptomatic shoulder pathology besides scapulothoracic bursitis. Even with poorer scores, patients are often satisfied and would undergo the procedure again.