PMID- 34890806
OWN - NLM
STAT- MEDLINE
DCOM- 20220523
LR  - 20220523
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 31
IP  - 6
DP  - 2022 Jun
TI  - Outcome of arthroscopic pectoralis minor release and scapulopexy for the 
      management of scapulothoracic abnormal motion.
PG  - 1208-1214
LID - S1058-2746(21)00828-4 [pii]
LID - 10.1016/j.jse.2021.10.046 [doi]
AB  - BACKGROUND: Management of persistent symptomatic scapulothoracic abnormal motion 
      (STAM) in the absence of periscapular muscle paralysis may be challenging. This 
      study reports the outcomes of arthroscopic pectoralis minor release and 
      scapulopexy for the management of symptomatic STAM secondary to pectoralis minor 
      hyperactivity and serratus anterior hypoactivity in the absence of periscapular 
      paralysis. METHODS: This was a retrospective cohort study with prospectively 
      collected data of patients with symptomatic STAM secondary to pectoralis minor 
      hyperactivity and serratus anterior hypoactivity. Surgery was indicated if 
      patients failed 6 months of conservative management. Patient outcomes were 
      assessed with shoulder range of motion (ROM) measurements, numerical pain scale, 
      shoulder subjective value (SSV), and Constant score. Data were analyzed with 
      Fischer's exact test for categorical variables and Student's t-test of unequal 
      variance for continuous and categorical variables. RESULTS: Thirty-one 
      consecutive patients were included in the study period between 2017 and 2020. 
      Average age at the time of surgery was 24 years (range, 14-44 years), 80% of 
      patients were female, and average follow-up after surgery was 23 months (range, 
      15-39 months). Thirteen patients also had a diagnosis of recurrent posterior 
      instability. At final follow-up, 81% reported significant improvements in their 
      STAM, as demonstrated by improved mean pain scale, ROM, SSV, and Constant scores. 
      Pain improved from 6 (range, 4-10) to 2 (range, 1-4), SSV from 30% (range, 
      10%-40%) to 75% (range, 60%-100%), and Constant score from 49 (range, 43-61) 
      preoperatively to 79 (range, 51-100) postoperatively (P < .01). All 13 patients 
      with recurrent associated posterior instability had resolution of their 
      instability. Flexion ROM improved from average 100 degrees  (range, 60 degrees -150 degrees ) to 140 degrees  
      (range, 120 degrees -160 degrees ). One patient had traumatic rupture of her scapulopexy 7 weeks 
      postoperatively and underwent revision scapulopexy. Thirteen percent had minimal 
      improvement after surgery and experienced recurrence 3 months postoperatively. 
      CONCLUSION: In patients with symptomatic STAM secondary to pectoralis minor 
      hyperactivity and serratus anterior hypoactivity, arthroscopic pectoralis minor 
      release and scapulopexy is an effective surgical option.
CI  - Copyright (c) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Elhassan, Bassem T
AU  - Elhassan BT
AD  - Harvard Shoulder Service, Massachusetts General Hospital, Boston, MA, USA. 
      Electronic address: belhassan@partners.org.
FAU - Dang, Khang H
AU  - Dang KH
AD  - Harvard Shoulder Service, Massachusetts General Hospital, Boston, MA, USA.
FAU - Huynh, Tiffany M
AU  - Huynh TM
AD  - Harvard Shoulder Service, Massachusetts General Hospital, Boston, MA, USA.
FAU - Harstad, Chelsea
AU  - Harstad C
AD  - Boston Clinical Trial, Boston, MA, USA.
FAU - Best, Matthew J
AU  - Best MJ
AD  - Harvard Sports Medicine Service, Massachusetts General Hospital, Boston, MA, USA.
LA  - eng
PT  - Journal Article
DEP - 20211207
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Arthroscopy
MH  - Female
MH  - Humans
MH  - *Joint Instability/surgery
MH  - Male
MH  - Pain
MH  - Paralysis
MH  - Pectoralis Muscles/physiology/surgery
MH  - Range of Motion, Articular/physiology
MH  - Retrospective Studies
MH  - *Shoulder Joint/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Scapula
OT  - pectoralis minor
OT  - scapulopexy
OT  - serratus anterior
EDAT- 2021/12/11 06:00
MHDA- 2022/05/24 06:00
CRDT- 2021/12/10 20:16
PHST- 2021/07/25 00:00 [received]
PHST- 2021/10/23 00:00 [revised]
PHST- 2021/10/30 00:00 [accepted]
PHST- 2021/12/11 06:00 [pubmed]
PHST- 2022/05/24 06:00 [medline]
PHST- 2021/12/10 20:16 [entrez]
AID - S1058-2746(21)00828-4 [pii]
AID - 10.1016/j.jse.2021.10.046 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2022 Jun;31(6):1208-1214. doi: 10.1016/j.jse.2021.10.046. 
      Epub 2021 Dec 7.