Skip to main content

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

  • Chapter
  • First Online:
Rotator Cuff Injuries

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  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.

    Article  CAS  PubMed  Google Scholar 

  2. Neer CS, Poppen NK. Supraspinatus outlet. Orthop Trans. 1987;11:234.

    Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  4. Seitz AL, et al. Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both? Clin Biomech (Bristol, Avon). 2011;26(1):1–12.

    Article  Google Scholar 

  5. Shaffer BS. Painful conditions of the acromioclavicular joint. J Am Acad Orthop Surg. 1999;7(3):176–88.

    Article  CAS  PubMed  Google Scholar 

  6. Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007;35(2):316–29.

    Article  PubMed  Google Scholar 

  7. Mall NA, et al. Degenerative joint disease of the acromioclavicular joint: a review. Am J Sports Med. 2013;41(11):2684–92.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  10. Ellman H. Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy. 1987;3(3):173–81.

    Article  CAS  PubMed  Google Scholar 

  11. Esch JC, et al. Arthroscopic subacromial decompression: results according to the degree of rotator cuff tear. Arthroscopy. 1988;4(4):241–9.

    Article  CAS  PubMed  Google Scholar 

  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. Tolin BS, Snyder SJ. Our technique for the arthroscopic Mumford procedure. Orthop Clin North Am. 1993;24(1):143–51.

    CAS  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  15. Koester MC, George MS, Kuhn JE. Shoulder impingement syndrome. Am J Med. 2005;118(5):452–5.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  17. McCallister WV, et al. Open rotator cuff repair without acromioplasty. J Bone Joint Surg Am. 2005;87(6):1278–83.

    PubMed  Google Scholar 

  18. Chen AL, Rokito AS, Zuckerman JD. The role of the acromioclavicular joint in impingement syndrome. Clin Sports Med. 2003;22(2):343–57.

    Article  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  20. Watson M. The refractory painful arc syndrome. J Bone Joint Surg Br. 1978;60-B(4):544–6.

    CAS  PubMed  Google Scholar 

  21. Cuomo F, et al. The influence of acromioclavicular joint morphology on rotator cuff tears. J Shoulder Elb Surg. 1998;7(6):555–9.

    Article  CAS  Google Scholar 

  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. Brown JN, et al. Shoulder pathology associated with symptomatic acromioclavicular joint degeneration. J Shoulder Elb Surg. 2000;9(3):173–6.

    Article  CAS  Google Scholar 

  24. Chronopoulos E, et al. Diagnostic value of physical tests for isolated chronic acromioclavicular lesions. Am J Sports Med. 2004;32(3):655–61.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. Wasserman BR, et al. Accuracy of acromioclavicular joint injections. Am J Sports Med. 2013;41(1):149–52.

    Article  PubMed  Google Scholar 

  28. Mumford EB. Acromioclavicular dislocation: a new operative treatment. J Bone Joint Surg Am. 1941;23:799–802.

    Google Scholar 

  29. Pensak M, et al. Open versus arthroscopic distal clavicle resection. Arthroscopy. 2010;26(5):697–704.

    Article  PubMed  Google Scholar 

  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.

    CAS  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  32. Rokito SE, Myers KR, Ryu RK. SLAP lesions in the overhead athlete. Sports Med Arthrosc. 2014;22(2):110–6.

    Article  PubMed  Google Scholar 

  33. Ortiguera CJ, Buss DD. Surgical management of the symptomatic os acromiale. J Shoulder Elb Surg. 2002;11(5):521–8.

    Article  Google Scholar 

  34. Youm T, et al. Os acromiale: evaluation and treatment. Am J Orthop (Belle Mead NJ). 2005;34(6):277–83.

    Google Scholar 

  35. Edelson JG, Zuckerman J, Hershkovitz I. Os acromiale: anatomy and surgical implications. J Bone Joint Surg Br. 1993;75(4):551–5.

    CAS  PubMed  Google Scholar 

  36. Mudge MK, Wood VE, Frykman GK. Rotator cuff tears associated with os acromiale. J Bone Joint Surg Am. 1984;66(3):427–9.

    Article  CAS  PubMed  Google Scholar 

  37. Warner JJ, Beim GM, Higgins L. The treatment of symptomatic os acromiale. J Bone Joint Surg Am. 1998;80(9):1320–6.

    Article  CAS  PubMed  Google Scholar 

  38. Campbell PT, Nizlan NM, Skirving AP. Arthroscopic excision of os acromiale: effects on deltoid function and strength. Orthopedics. 2012;35(11):e1601–5.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  41. Kurtz CA, et al. Symptomatic os acromiale. J Am Acad Orthop Surg. 2006;14(1):12–9.

    Article  PubMed  Google Scholar 

  42. McClure JG, Raney RB. Anomalies of the scapula. Clin Orthop Relat Res. 1975;110:22–31.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  45. Hertel R, et al. Transacromial approach to obtain fusion of unstable os acromiale. J Shoulder Elb Surg. 1998;7(6):606–9.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mathew J. Hamula M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Hamula, M.J., Rokito, A.S. (2018). Arthroscopic Treatment of Rotator Cuff Tendonitis Including Treatment of Acromioclavicular Joint Osteoarthritis and Os Acromiale. In: McMahon, P. (eds) Rotator Cuff Injuries. Springer, Cham. https://doi.org/10.1007/978-3-319-63668-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-63668-9_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63666-5

  • Online ISBN: 978-3-319-63668-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics