title: Arthroscopic management of the painful snapping scapula.
abstract: OBJECTIVE
  The aim of this study was to evaluate the results of the arthroscopic management of the snapping scapula syndrome.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Thirteen patients underwent surgery for painful scapular snapping that had not responded to adequate conservative treatment. They had no evidence of anatomic abnormalities on plain radiographs. All patients underwent bursectomy and resection of bands of fibrous tissue at the superomedial angle. Bone was resected from the superomedial angle only if it appeared to be prominent during arthroscopy. This occurred in 3 cases. The patients' outcomes were assessed subjectively by their ability to return to work and their return to leisure, as well as the Constant score.
  
  
  RESULTS
  At the time of follow-up, 9 patients (69%) reported an improvement in their symptoms. Their median Constant score was 87 (range, 95 to 58). Four patients felt that their symptoms were unchanged or worse. Their median Constant score was 55 (range, 66 to 32). Of 9 employed patients, 8 returned to their previous careers. This group included 2 patients with physically demanding jobs. Of 9 patients who played sports regularly, 6 returned to their presymptomatic level of sporting activity. There were no complications.
  
  
  CONCLUSIONS
  Subscapular bursectomy is a safe procedure with a low rate of morbidity. In the absence of a definable anatomic abnormality, arthroscopic bursectomy for the painful snapping scapula can result in satisfactory outcomes in approximately 70% of patients. More clearly defined indications for and contraindications against surgery are required to avoid poor results. Complete resolution of the snapping in the subscapular bursa is not necessary to obtain a satisfactory result.
  
  
  METHODS
  Level IV, case series, no control group.
authors.affiliation: Reading Shoulder Unit, Royal Berkshire Hospital, Reading, England. YemiPearse@aol.com
authors.forename: Eyiyemi O
authors.initials: EO
authors.lastname: Pearse
authors.forename: Juan
authors.initials: J
authors.lastname: Bruguera
authors.forename: Samir N
authors.initials: SN
authors.lastname: Massoud
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sforza
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Copeland
authors.forename: Ofer
authors.initials: O
authors.lastname: Levy
mesh_terms: D000328:Adult; D001182:Arthroscopy; D002061:Bursa, Synovial / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012540:Scapula; D020069:Shoulder Pain / Q000503:physiopathology / Q000601:surgery*; D013577:Syndrome; D016896:Treatment Outcome