PMID- 32888981
OWN - NLM
STAT- MEDLINE
DCOM- 20210405
LR  - 20210405
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 36
IP  - 12
DP  - 2020 Dec
TI  - Prognosis After Arthroscopic Superior Medial Scapuloplasty for Snapping Scapula 
      Syndrome Improves After a Transient Beneficial Response With an Ultrasound-Guided 
      Subscapular Cortisone Injection.
PG  - 2965-2972
LID - S0749-8063(20)30622-8 [pii]
LID - 10.1016/j.arthro.2020.07.024 [doi]
AB  - PURPOSE: To evaluate the prognostic value of an ultrasound-guided subscapular 
      local anesthetic and cortisone injection in a consecutive series of patients who 
      underwent an arthroscopic superior medial scapuloplasty for snapping scapula 
      syndrome (SSS) and had been refractory to conservative treatment. METHODS: We 
      undertook an arthroscopic superior medial scapuloplasty on patients with a 
      clinical diagnosis of SSS who had failed a structured physiotherapy program and 
      had either gained a good response or no to minimal response to preoperative 
      ultrasound-guided subscapular local anesthetic and cortisone injection. The 
      patients were assessed preoperatively and at final follow-up with the QuickDASH 
      and Constant scores, and their pain was assessed with a visual analog scale 
      (VAS). RESULTS: Between January 2009 and December 2016, 47 patients were included 
      in the study, with a minimal follow-up of 2 years. There were 29 female and 18 
      male patients, and the mean age at the time of surgery was 27.4 years (range 15 
      to 61). Forty-two patients were available at final follow-up. There were 31 
      patients in the good response group and 11 patients in the no to minimal response 
      group. For all patients, the mean time to follow-up was 41.8 months (range 24 to 
      108). There was a significant improvement after surgery in the mean QuickDASH 
      score (from 39 to 20, P < .001) (minimal clinically important difference [MCID] 
      15.91) , Constant score (from 57 to 87, P < .001) (MCID 10.4), and VAS (from 6 to 
      2, P < .001) (MCID 3). For the good response group, there was a significant 
      improvement after surgery in the mean QuickDASH score (from 38 to 18, P < .001) 
      (MCID 15.91), the Constant score (from 57 to 89) (MCID 10.4), and the VAS (from 6 
      to 2, P < .001) (MCID 3). For the no to minimal response group, there was a 
      significant improvement after surgery in the mean QuickDASH score (from 42 to 24, 
      P < .01) (MCID 15.91), the Constant score (from 58 to 80, P < .002) (MCID 10.4), 
      and the VAS (from 6 to 2, P < .01) (MCID 3). The difference in postoperative 
      improvement of the QuickDASH and Constant scores between the good response and 
      the no to minimal response groups was statistically significant (P < .05). 
      CONCLUSION: The results of this study suggest that arthroscopic scapuloplasty can 
      lead to a significant improvement in pain and function in all patients with a 
      clinical diagnosis of snapping scapula syndrome refractory to conservative 
      treatment. Patients who gained a good transient response to a preoperative 
      ultrasound-guided subscapular cortisone injection obtained a significantly better 
      recovery than those who did not. A preoperative ultrasound-guided subscapular 
      cortisone injection appeared to be of prognostic value.
CI  - Crown Copyright (c) 2020. Published by Elsevier Inc. All rights reserved.
FAU - Tytherleigh-Strong, Graham
AU  - Tytherleigh-Strong G
AD  - Division of Orthopaedics, Addenbrookes Hospital, Cambridge University Hospitals 
      NHS Trust, Cambridge, UK. Electronic address: 
      graham.tytherleigh-strong@addenbrookes.nhs.uk.
FAU - Gill, James
AU  - Gill J
AD  - Division of Orthopaedics, Addenbrookes Hospital, Cambridge University Hospitals 
      NHS Trust, Cambridge, UK.
FAU - Griffiths, Emmet
AU  - Griffiths E
AD  - Division of Orthopaedics, Addenbrookes Hospital, Cambridge University Hospitals 
      NHS Trust, Cambridge, UK.
FAU - Al-Hadithy, Nawfal
AU  - Al-Hadithy N
AD  - Division of Orthopaedics, Addenbrookes Hospital, Cambridge University Hospitals 
      NHS Trust, Cambridge, UK.
LA  - eng
PT  - Journal Article
DEP - 20200902
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
RN  - V27W9254FZ (Cortisone)
SB  - IM
CIN - Arthroscopy. 2020 Dec;36(12):2973-2974. PMID: 33276885
MH  - Adolescent
MH  - Adult
MH  - Arthroscopy/*methods
MH  - Cortisone/*administration & dosage
MH  - Female
MH  - Humans
MH  - Injections
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Pain Measurement
MH  - Postoperative Period
MH  - Prognosis
MH  - Scapula/*surgery
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - *Ultrasonography, Interventional
MH  - Visual Analog Scale
MH  - Young Adult
EDAT- 2020/09/06 06:00
MHDA- 2021/04/07 06:00
CRDT- 2020/09/05 12:20
PHST- 2019/12/08 00:00 [received]
PHST- 2020/07/06 00:00 [revised]
PHST- 2020/07/15 00:00 [accepted]
PHST- 2020/09/06 06:00 [pubmed]
PHST- 2021/04/07 06:00 [medline]
PHST- 2020/09/05 12:20 [entrez]
AID - S0749-8063(20)30622-8 [pii]
AID - 10.1016/j.arthro.2020.07.024 [doi]
PST - ppublish
SO  - Arthroscopy. 2020 Dec;36(12):2965-2972. doi: 10.1016/j.arthro.2020.07.024. Epub 
      2020 Sep 2.