A Clinical Study Of Arthroscopic Subcromial Decompression For The Treatment Of Subcromial Impingement Syndrome

Objective:This study examines the treatment of subacromial impingement syndrome and the clinical efficacy with using Arthroscopic subcromial decompression(ASD) .Methods: Since April 2005~December 2010 in our hospital 36 patients with subacromial impingement syndrome underwent Arthroscopic subcromial decompression(ASD).And all the patiens allowed a follow-up visit, including 23 male patients and 13 female patients ;Right shoulder in 28 cases,8 cases of left shoulder .The average age of patients was 49.9(from 32 to 65).According to Neer classification,2 cases wereⅠdegree of injury,16 cases wereⅡdegree,and 18 cases wereⅢdegree .According to UCLA score,this group of patients with preoperative score was 16.14±2.10 points.Neer impingement sign positive for 28 patients, 60 o -120 o arc test was positive in 25 cases of pain. Neer impingement sign positive for 28 patients with 1% lidocaine 10ml caught subacromial space for ciosed test,the pain disappeared or significantly reduced.Conventional X-ray for anteroposterior view of the shoulder, and axillary view and supraspinatus outlet view were obtained before surgery. With Bigliani's classification of acromion morphology:flat acromion is 4 cases,curved acromion 24 cases,and hooked 8 cases. 31 cases of shoulder MRI or MRA.The procedure of Arthroscopic subacromial decompression (ASD)as follows: acromion lateral approach into electric planer and radio frequency,the removal of subacromial bursea, Rf cut or part to cut off the coracoacromial ligament and burning bleeding points; acromion lateral approach into the burr,polished the front edge of the acromion, The posterior portal into power drill,to have removed some parts and did not remove the ridge between the polished;Acromioclavicular joint exploration and, if the proliferation of osteophytes, are used to remove the burr;Full-thickness rotator cuff tear or partial tear of the lateral synovial who use endoscopic suture anchor line. Early postoperative do practice shoulder function.Results: All patients were followed up for 100%, up from 3 ~ 56 months, an average of 25.9 months.The average score after25.9 months was 31.67±2.47. Preoperative score was 16.14±2.10 points.Line their own t test before and after surgery, the difference was significant (t=37.08,P<0.01). 6 patients achieved excellent (Excellent), 25 patients achieved good (Good), 5 patients achieved can be (fair), All patients return to normal life and movement, excellent rate of 86.1%.Conclusion: Subacromial impingement syndrome refers to all causes subacromial narrow passageways, when shoulder flexion, abduction, humeral greater tuberosity and the coracoacromial arch repeated impact, leading to symptoms of subacromial bursitis, rotator cuff tissue degeneration, or rotator cuff tear, shoulder pain and dysfunction caused by a series of symptoms. Subacromial impingement syndrome diagnosis should be integrated preoperative history, physical examination, X-ray, MRI ,combined with endoscopic surgery in the specific pathological changes, decided to surgical programs. Arthroscopic subacromial decompression treatment of subacromial impingement syndrome is an effective method. It has a mini-trauma, intuitive, less postoperative pain, fewer complications, faster recovery and starting rehabilitation at the early stage, and so on merit. Recent mid-term results were satisfactory, long-term effect needs further follow-up.