Narrowing the Options for Shoulder Impingement Surgery Enlarges the ResultsIn the 1970s, doctors found a way to surgically relieve shoulder pain caused by impingement. Impingement means something is getting pinched. In the shoulder, impingement usually involves a tendon or bursa that is getting pinched between the shoulder bones. The bursa is a fluid-filled sac that reduces friction between the tendon and the bone.
Impingement surgery involves opening the joint and removing part of the bone, ligament, or bursa. This is called surgical decompression. The result is pain relief and increased shoulder motion and function.
In the 1980s, doctors improved on this operation. Using a new tool called an arthroscope, doctors could perform this same operation without cutting open the shoulder. Now, doctors are trying to further improve results.
They want to know which one of the structures involved is the main problem. Is it thickening of the bone, the ligament, the bursa, or all three? How much bone should be cut away? Doctors decide this at the time of the operation. The decision is based on experience and judgment.
Doctors in France studied 41 shoulders using X-rays and imaging before and after the surgery. They found that the success of the operation doesn't always depend on how much of the bone is cut away. Results of the decompression likely depends on several factors.
The next step is to see if the good results come from simply removing the bursa. A new study by these researchers is already underway.
Jacques Soyer, MD, et al. The Relationship Between Clinical Outcomes and the Amount of Arthroscopic Acromial Resection. In Arthroscopy. January 2003. Vol. 19. No. 1. Pp. 34-39.
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