Literature supports initial nonoperative management regardless of the etiology of the scapulothoracic pain. It is recognized, however, that bursitis occurring in the absence of an anatomic lesion responds more favorably to nonoperative management than when an anatomic lesion can be identified. When symptoms do not respond to nonsurgical measures or in the presence of structural abnormalities, surgical intervention is often necessary. Open techniques have historically resulted in substantial symptomatic relief. However, release of muscular insertions from the scapula can result in considerable morbidity and may slow rehabilitation.
Recently, arthroscopic techniques have been developed to minimize surgical morbidity, improve cosmesis, and accelerate rehabilitation. An understanding of the arthroscopic anatomy is critical to avoid the numerous neurovascular structures in this area, yet it is unfamiliar to many surgeons. There are also few clinical reports available to gauge the efficacy of an arthroscopic technique. The purpose of this study was to present the surgical outcomes of a large consecutive series of patients with scapulothoracic bursitis and describe an arthroscopic approach to scapulothoracic bursectomy and partial scapulectomy. It was our hypothesis that arthroscopic scapulothoracic bursectomy and partial scapulectomy would result in improved subjective shoulder outcome scores at a minimum of 2 years’ follow-up.
Full Article: Technique and Outcomes of Arthroscopic Scapulothoracic Bursectomy and Partial Scapulectomy