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Arthroscopic Treatment of Rotator Cuff Tendonitis Including Treatment of Acromioclavicular Joint Osteoarthritis and Os Acromiale

  • Mathew J. Hamula
  • Andrew S. Rokito
Chapter

Abstract

Rotator cuff (RTC) tendonitis is a common shoulder pathology originating from a variety of extrinsic factors, intrinsic pathology, or a combination of both. It can be challenging to diagnose the underlying issue; however it is imperative to identify in order to select the appropriate treatment and optimize outcomes. The mainstay of treatment is nonoperative management. Following an adequate trial of non-operative management, surgical intervention may be warranted and should address the concomitant pathology including osseous and soft tissue sources of extrinsic compression. Anatomical variations of the acromion should be identified and addressed when appropriate. Surgeons should also take into consideration the distal clavicle and acromioclavicular joint as possible sources of symptoms. A careful history and physical exam in conjunction with radiographs and advanced imaging can assist in the appropriate treatment of patients with rotator cuff tendonitis that have failed nonoperative management.

Keywords

Rotator cuff tendonitis Diagnosis Management Os acromiale Shoulder arthroscopy Distal clavicle resection 

References

  1. 1.
    Luime JJ, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004;33(2):73–81.CrossRefPubMedGoogle Scholar
  2. 2.
    Neer CS, Poppen NK. Supraspinatus outlet. Orthop Trans. 1987;11:234.Google Scholar
  3. 3.
    Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54(1):41–50.CrossRefPubMedGoogle Scholar
  4. 4.
    Seitz AL, et al. Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both? Clin Biomech (Bristol, Avon). 2011;26(1):1–12.CrossRefGoogle Scholar
  5. 5.
    Shaffer BS. Painful conditions of the acromioclavicular joint. J Am Acad Orthop Surg. 1999;7(3):176–88.CrossRefPubMedGoogle Scholar
  6. 6.
    Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007;35(2):316–29.CrossRefPubMedGoogle Scholar
  7. 7.
    Mall NA, et al. Degenerative joint disease of the acromioclavicular joint: a review. Am J Sports Med. 2013;41(11):2684–92.CrossRefPubMedGoogle Scholar
  8. 8.
    Beitzel K, et al. Sequential resection of the distal clavicle and its effects on horizontal acromioclavicular joint translation. Am J Sports Med. 2012;40(3):681–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Stine IA, Vangsness CT Jr. Analysis of the capsule and ligament insertions about the acromioclavicular joint: a cadaveric study. Arthroscopy. 2009;25(9):968–74.CrossRefPubMedGoogle Scholar
  10. 10.
    Ellman H. Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy. 1987;3(3):173–81.CrossRefPubMedGoogle Scholar
  11. 11.
    Esch JC, et al. Arthroscopic subacromial decompression: results according to the degree of rotator cuff tear. Arthroscopy. 1988;4(4):241–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Kay SP, Ellman H, Harris E. Arthroscopic distal clavicle excision. Technique and early results. Clin Orthop Relat Res. 1994;301:181–4.Google Scholar
  13. 13.
    Tolin BS, Snyder SJ. Our technique for the arthroscopic Mumford procedure. Orthop Clin North Am. 1993;24(1):143–51.PubMedGoogle Scholar
  14. 14.
    Frieman BG, Albert TJ, Fenlin JM Jr. Rotator cuff disease: a review of diagnosis, pathophysiology, and current trends in treatment. Arch Phys Med Rehabil. 1994;75(5):604–9.PubMedGoogle Scholar
  15. 15.
    Koester MC, George MS, Kuhn JE. Shoulder impingement syndrome. Am J Med. 2005;118(5):452–5.CrossRefPubMedGoogle Scholar
  16. 16.
    MacDonald PB, Clark P, Sutherland K. An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial impingement signs. J Shoulder Elb Surg. 2000;9(4):299–301.CrossRefGoogle Scholar
  17. 17.
    McCallister WV, et al. Open rotator cuff repair without acromioplasty. J Bone Joint Surg Am. 2005;87(6):1278–83.PubMedGoogle Scholar
  18. 18.
    Chen AL, Rokito AS, Zuckerman JD. The role of the acromioclavicular joint in impingement syndrome. Clin Sports Med. 2003;22(2):343–57.CrossRefPubMedGoogle Scholar
  19. 19.
    Kessel L, Watson M. The painful arc syndrome. Clinical classification as a guide to management. J Bone Joint Surg Br. 1977;59(2):166–72.PubMedGoogle Scholar
  20. 20.
    Watson M. The refractory painful arc syndrome. J Bone Joint Surg Br. 1978;60-B(4):544–6.PubMedGoogle Scholar
  21. 21.
    Cuomo F, et al. The influence of acromioclavicular joint morphology on rotator cuff tears. J Shoulder Elb Surg. 1998;7(6):555–9.CrossRefGoogle Scholar
  22. 22.
    Petersson CJ, Gentz CF. Ruptures of the supraspinatus tendon. The significance of distally pointing acromioclavicular osteophytes. Clin Orthop Relat Res. 1983;174:143–8.Google Scholar
  23. 23.
    Brown JN, et al. Shoulder pathology associated with symptomatic acromioclavicular joint degeneration. J Shoulder Elb Surg. 2000;9(3):173–6.CrossRefGoogle Scholar
  24. 24.
    Chronopoulos E, et al. Diagnostic value of physical tests for isolated chronic acromioclavicular lesions. Am J Sports Med. 2004;32(3):655–61.CrossRefPubMedGoogle Scholar
  25. 25.
    O’Brien SJ, et al. The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med. 1998;26(5):610–3.CrossRefPubMedGoogle Scholar
  26. 26.
    Bookman JS, Pereira DS. Ultrasound guidance for intra-articular knee and shoulder injections: a review. Bull Hosp Jt Dis (2013). 2014;72(4):266–70.Google Scholar
  27. 27.
    Wasserman BR, et al. Accuracy of acromioclavicular joint injections. Am J Sports Med. 2013;41(1):149–52.CrossRefPubMedGoogle Scholar
  28. 28.
    Mumford EB. Acromioclavicular dislocation: a new operative treatment. J Bone Joint Surg Am. 1941;23:799–802.Google Scholar
  29. 29.
    Pensak M, et al. Open versus arthroscopic distal clavicle resection. Arthroscopy. 2010;26(5):697–704.CrossRefPubMedGoogle Scholar
  30. 30.
    Bhatnagar A, Bhonsle S, Mehta S. Correlation between MRI and arthroscopy in diagnosis of shoulder pathology. J Clin Diagn Res. 2016;10(2):RC18–21.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Lubowitz JH. Editorial commentary: lesions of the superior labrum from anterior to posterior (SLAP) are a slap in the face to the traditional trinity of history, examination, and imaging. Arthroscopy. 2015;31(12):2470–1.CrossRefPubMedGoogle Scholar
  32. 32.
    Rokito SE, Myers KR, Ryu RK. SLAP lesions in the overhead athlete. Sports Med Arthrosc. 2014;22(2):110–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Ortiguera CJ, Buss DD. Surgical management of the symptomatic os acromiale. J Shoulder Elb Surg. 2002;11(5):521–8.CrossRefGoogle Scholar
  34. 34.
    Youm T, et al. Os acromiale: evaluation and treatment. Am J Orthop (Belle Mead NJ). 2005;34(6):277–83.Google Scholar
  35. 35.
    Edelson JG, Zuckerman J, Hershkovitz I. Os acromiale: anatomy and surgical implications. J Bone Joint Surg Br. 1993;75(4):551–5.PubMedGoogle Scholar
  36. 36.
    Mudge MK, Wood VE, Frykman GK. Rotator cuff tears associated with os acromiale. J Bone Joint Surg Am. 1984;66(3):427–9.CrossRefPubMedGoogle Scholar
  37. 37.
    Warner JJ, Beim GM, Higgins L. The treatment of symptomatic os acromiale. J Bone Joint Surg Am. 1998;80(9):1320–6.CrossRefPubMedGoogle Scholar
  38. 38.
    Campbell PT, Nizlan NM, Skirving AP. Arthroscopic excision of os acromiale: effects on deltoid function and strength. Orthopedics. 2012;35(11):e1601–5.CrossRefPubMedGoogle Scholar
  39. 39.
    Abboud JA, et al. Surgical treatment of os acromiale with and without associated rotator cuff tears. J Shoulder Elb Surg. 2006;15(3):265–70.CrossRefGoogle Scholar
  40. 40.
    Johnston PS, et al. Os acromiale: a review and an introduction of a new surgical technique for management. Orthop Clin North Am. 2013;44(4):635–44.CrossRefPubMedGoogle Scholar
  41. 41.
    Kurtz CA, et al. Symptomatic os acromiale. J Am Acad Orthop Surg. 2006;14(1):12–9.CrossRefPubMedGoogle Scholar
  42. 42.
    McClure JG, Raney RB. Anomalies of the scapula. Clin Orthop Relat Res. 1975;110:22–31.CrossRefGoogle Scholar
  43. 43.
    Nicholson GP, et al. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elb Surg. 1996;5(1):1–11.CrossRefGoogle Scholar
  44. 44.
    Uri DS, Kneeland JB, Herzog R. Os acromiale: evaluation of markers for identification on sagittal and coronal oblique MR images. Skelet Radiol. 1997;26(1):31–4.CrossRefGoogle Scholar
  45. 45.
    Hertel R, et al. Transacromial approach to obtain fusion of unstable os acromiale. J Shoulder Elb Surg. 1998;7(6):606–9.CrossRefGoogle Scholar
  46. 46.
    Peckett WR, et al. Internal fixation of symptomatic os acromiale: a series of twenty-six cases. J Shoulder Elb Surg. 2004;13(4):381–5.CrossRefGoogle Scholar
  47. 47.
    Atoun E, et al. Arthroscopically assisted internal fixation of the symptomatic unstable os acromiale with absorbable screws. J Shoulder Elb Surg. 2012;21(12):1740–5.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, NYU Langone Medical CenterNYU Hospital for Joint DiseasesNew YorkUSA

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