Non-Operative Treatment of Subacromial Impingement Syndrome*

  title={Non-Operative Treatment of Subacromial Impingement Syndrome*},
  author={David Scott Morrison and Anthony D. Frogameni and Paul M. Woodworth},
  journal={The Journal of Bone \& Joint Surgery},
We performed a retrospective study of 616 patients (636 shoulders) who had subacromial impingement syndrome to assess the results of non-operative treatment. The diagnosis was made on the basis of a positive impingement sign and the absence of other abnormalities of the shoulder, such as full-thickness tears of the rotator cuff, osteoarthrosis of the acromioclavicular joint, instability of the glenohumeral joint, or adhesive capsulitis. All patients were managed with anti-inflammatory… 

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Arthroscopic subacromial decompression is effective in selected patients with shoulder impingement syndrome.

Arthroscopic SAD is a beneficial intervention in selected patients with symptoms for over six months due to subacromial impingement of the shoulder and four criteria could help identify patients in whom it is likely to be most effective.

Peripheral paresthesia in patients with subacromial impingement syndrome

Some patients with subacromial impingements syndrome report associated peripheral paresthesia radiating to hand, which is strongly associated with the age, pain level and the grade of impingement, and the incidence and aetiology is the subject of further studies.

Arthroscopic decompression and physiotherapy have similar effectiveness for subacromial impingement.

Investigation for stability of the shoulder joint under general anesthesia followed by arthroscopic examination of the glenohumeral joint, the rotator cuff, and the subacromial bursa and two experienced surgeons did bursectomy with partial resection of the anteroinferior part of the acromion and coracoacromia ligament.

Impingement syndrome: temporal outcomes of nonoperative treatment.

Medium-term natural history of subacromial impingement syndrome.

Surgical management of the subacromial arch: Arthroscopic techniques for subacromial decompression, acromioplasty, and distal clavicle resection

Treatment for impingement syndrome ranges from nonoperative management with nonsteroidal anti-inflammatories, physical therapy, and steroid injections to subacromial decompression, acromioplasty, distal clavicle resection, and rotator cuff repair.

Current Concepts Review - Subacromial Impingement Syndrome*

It is important to differentiate subacromial impingement syndrome from other conditions that may cause symptoms in the shoulder, such as glenohumeral instability, cervical radiculitis, calcific tendinitis, adhesive capsulitis), degenerative joint disease, isolated acromioclavicular osteoarthrosis, and nerve compression.

The role of acromion morphology in chronic subacromial impingement syndrome.

In this study, acromion type was not found to have an important role in the aetiology of chronic impingement syndrome; arthroscopic subacromial decompression without simultaneous acromioplasty thus appears as an appropriate treatment.

No evidence of long-term benefits of arthroscopic acromioplasty in the treatment of shoulder impingement syndrome

Structured exercise treatment seems to be the treatment of choice for shoulder impingement syndrome, and differences in the patient-centred primary and secondary parameters between the two treatment groups were not statistically significant, suggesting that acromioplasty is not cost-effective.



Arthroscopic subacromial decompression: analysis of one- to three-year results.

  • H. Ellman
  • Medicine
    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
  • 1987

Arthroscopic acromioplasty. Technique and results.

Of forty-four patients who were treated by arthroscopic acromioplasty from July 1984 through August 1986, forty were available for analysis, and, over-all, thirty-eight (92 per cent) of the forty patients were satisfied with the result.

Impingement syndrome. A review of late stage II and early stage III lesions.

The results indicate that anterior acromioplasty is an excellent procedure for relief of pain due to impingement and beneficial results were obtained in range of motion and muscle strength.

Coracoacromial ligament division

The operation was judged to be simple and effective for treatment of persistent painful arc syndrome secondary to cora coacromial ligament inflammation.

The difficulties in assessment of results of anterior acromioplasty.

The criteria defined by Neer, and based on patient satisfaction, minimal pain, full use of the shoulder, less than 20 degrees of limitation of overhead extension, and at least 75% of normal strength, provided the most accurate assessments for this series and resulted in a satisfactory outcome for 60% of the patients.

Shoulder impingement syndrome. Results of operative release.

For the release of mechanical impingement occurring during the movement of the humeral head and its overlying rotator cuff beneath the coracoacromial arch, 21 patients who had a painful arc resistant

The painful arc syndrome. Clinical classification as a guide to management.

Excision of the outer end of the clavicle and division of the coraco-acromial ligament abolished the pain in most cases.

Shoulder impingement syndrome in athletes treated by an anterior acromioplasty.

This operation is satisfactory for pain relief but does not allow an athlete to return to his former competitive status, and a prolonged rehabilitation program may improve the results.

Diagnosis and treatment of incomplete rotator cuff tears.

  • H. Ellman
  • Medicine
    Clinical orthopaedics and related research
  • 1990
A system of grading partial-thickness tears based on location, depth, and area is presented in an effort to standardize the observations of various investigators and to permit comparison of the results of arthroscopic treatment.

Shoulder impingement syndrome. A critical review.

Information from this review and clinical practice permits differentiation of the two distinct etiologies of RCT which is important in treatment planning.