title: Arthroscopic Treatment of Snapping Scapula Syndrome: Outcomes at Minimum of 2 Years.
abstract: OBJECTIVE
  To investigate clinical outcomes after primary and revision arthroscopic treatment for snapping scapula syndrome (SSS) and identify predictive factors associated with outcomes.
  
  
  METHODS
  Patients who underwent arthroscopic treatment for SSS between October 2005 and December 2013 were identified in a prospectively collected database. The inclusion criteria were patients with a diagnosis of symptomatic SSS, in whom extensive nonoperative modalities failed, who underwent arthroscopic surgery for SSS, and who had undergone surgery a minimum of 2 years earlier. Postoperative clinical outcomes were assessed with the American Shoulder and Elbow Surgeons score; short version of the Disabilities of the Arm, Shoulder and Hand questionnaire; and general health Short Form 12 (SF-12) scores, including both physical component summary and mental component summary. Patient satisfaction was recorded on a 10-point visual analog scale. Scapular bony morphology was determined on preoperative magnetic resonance imaging.
  
  
  RESULTS
  Ninety-two scapulae underwent arthroscopic treatment for SSS. There were 74 scapulae that met the inclusion criteria, including having undergone surgery a minimum of 2 years earlier. An outcome questionnaire was completed for 60 of 74 (81%). The mean age was 33 years (range, 12-65 years), and the mean duration of symptoms before surgery was 4 years (range, 90 days to 20.4 years). The mean follow-up period was 3.4 years (range, 2-7 years). Eight scapulae failed initial surgical management (10.9%) because of recurrent pain and underwent revision surgery at a mean of 309 days (range, 120-917 days). After surgery, there was a significant improvement in all outcome scores, including SF-12 physical component summary score, from 39.2 to 45.4 (P = .002); SF-12 mental component summary score, from 45.0 to 49.6 (P = .023); American Shoulder and Elbow Surgeons score, from 52.6 to 75.8 (P < .001); and score on the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire, from 40.2 to 24.2 (P = .001). The median patient satisfaction rating was 7 of 10. Greater age, lower preoperative psychological score, and longer duration of symptoms before surgery correlated with lower postoperative outcome scores.
  
  
  CONCLUSIONS
  Arthroscopic surgery is an effective treatment for SSS in both primary and revision cases, showing significant improvements in all postoperative outcome scores at a mean of 3.4 years. Lower preoperative mental status score, longer duration of symptoms, and greater age were associated with poorer outcomes.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.
authors.forename: Travis J
authors.initials: TJ
authors.lastname: Menge
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
authors.forename: Marilee P
authors.initials: MP
authors.lastname: Horan
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
authors.forename: Dimitri S
authors.initials: DS
authors.lastname: Tahal
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Mitchell
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
authors.forename: J Christoph
authors.initials: JC
authors.lastname: Katthagen
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.. Electronic address: drmillett@thesteadmanclinic.com.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Millett
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D002062:Bursitis / Q000601:surgery*; D002648:Child; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D012540:Scapula / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery*; D055815:Young Adult