Arthroscopic Acromioplasty For The Treatment Of Impingement Syndrome Of The Shoulder

Objective The concept of impingement syndrome of the shoulder was defined by Neer CS in 1972. It is one of the most common causes for the pain and disfunction of the shoulder. It was treated by foreign and domestic orthopeadic surgeons with open surgery before. With the development of arthroscopic techniques, Dr. Ellman first reported the methods and the results of arthroscopic acromioplasty for the tratment of impingement syndrome of the shoulder. Later many doctors in the foreign country reported this arthroscopic surgery,and got good results .But in our country no one reports this kind of surgery before still. We had done this surgery for the impingement syndrome of the shoulder from January 2001 to May 2003. The purgose of this article is to study the methods and the clinical results of the Arthroscopic acromioplasty for the treatment of impingement syndrome of the shoulder.Methods Ten cases of impingement syndrome of shoulder were included, six cases were male, and four cases were female. Eight cases were right shoulder; two were left .The average age were 46 years old. According to Neers classification, one cases were I degree of injury,tree cases were II degree, and six cases were III degree. Pre-operative average scores of the involved Shoulders with UCLA were 16.4+4.7. Painful arch test (+) was seven cases. Impingment sign (+) was eight .X-ray for AP view of the shoulder ,and supraspinatus outlet view and view of acromion angled 30 degree caudal were obtained before surgery. With Bigliani's classification of acromion morphology: flat acromion is two cases, curved acomion 3 cases ,and hooked five cases. The procedure of arthroscopic acromioplasty: 1. Arthroscopic subacromial inspection with posterior portal. 2. Subacromial bursectomy with electro-shaver or burr. 3. To release or resect the C.A.ligament with electrocautery. 4. Subacromial decompression with full-radius resector or burr. 5. To debride the soft tissue around the AC joint and resect the spur.Results Ten cases were followed up. The average time of follow-up was sixteen months. Post-operative average scores for sixteen months later was 30.6 8. 4. Compared with the score of pre-operative group , the difference between the two group were significant(t=3.35,P<0.05). Andfour cases got excellent results, four cases got good results, one were fair and one were poor.Conclusion The impingement syndrome of the shoulder is the conditon of comprssion of the supraspinatus tendon against the anterior edge of the acromion ,the coraco-acromial ligament ,and at times, a projecting spur localized to the acromioclavicular joint. This chronic repetitive micotrauma causes a progressive imflammatory process and a subsequent degenerative process within the rotator cuff accompanied by pain and weakness of the shoulder. The diagnosis of impingement syndrome of the shoulder should be definite by the conbination of patient disease histry ,physical examination, X-ray film and MRI, and the pathology got in the surgery. arthroscopic acromioplasty is a reliable way to treat impingement of the shoulder. And this kind of surgery has the advantages of mini-trauma, recovery quickly and starting rehabilitation at the early stage.