Shoulder impingement syndromes in athletes and their surgical management*

Penny, J. Norgrove; Welsh, R. P.

doi:10.1177/036354658100900102

Cited by 97 publications

(19 citation statements)

References 10 publications

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“…It is often stated that in most instances overuse of the affected arm is the basic cause of impingement. 8,9 Our study aimed to identify common factors which may point to the underlying cause of the chronic impingement syndrome in patients who were selected for arthroscopic subacromial decompression. The effectiveness of this procedure and rate of recovery after surgery were also assessed to identify factors which influence the outcome.…”

mentioning

confidence: 99%

Treatment of Chronic Rotator-Cuff Impingement by Arthroscopic Subacromial Decompression

Nutton

McBirnie

Phillips

1997

The Journal of Bone and Joint Surgery. British volume

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We report a prospective study of 49 patients who had arthroscopic subacromial decompression for chronic rotator-cuff impingement. All patients were assessed preoperatively and at 3, 6 and 12 months using the modified UCLA shoulder score.The dominant arm was affected in 35 patients, but only 13 recognised overuse as a cause of their shoulder pain. Before operation, the UCLA shoulder score was poor or fair in all patients. After three months only 28% of patients had satisfactory relief of symptoms but at one year 85% of patients examined had a good or excellent result. Patients with calcific tendonitis recovered more quickly: 93% reported a good result at six months.We conclude that arthroscopic subacromial decompression is an effective form of treatment, but that patients should be warned that recovery from surgery may be prolonged. [Br] 1997;79-B:73-6. Received 16 May 1996; Accepted after revision 20 September 1996 The expression 'impingement of the rotator cuff' was used by Neer 1 who described changes in the rotator-cuff tendon due to abrasion and pressure from the anterior edge of the acromion and the coracoacromial ligament. He later delineated three stages of rotator-cuff disease from reversible inflammation (stage I) to full-thickness tear of the tendon (stage III). 2 Stage-II changes were described as chronic inflammation and fibrosis, possibly including partial-thickness tears of the cuff. These are common findings at operations for decompression in patients with persistent symptoms which have not responded to conservative treatment The underlying causes of rotator-cuff impingement may be subdivided into intrinsic disorders of the rotator cuff and extrinsic pressure from the coracoacromial arch. In intrinsic disorders, the tendon is thickened and inflamed at areas of calcification, swollen at the site of partial cuff tears, or covered by a chronically inflamed and indurated subacromial bursa. In extrinsic cases, the shape of the acromion, Our study aimed to identify common factors which may point to the underlying cause of the chronic impingement syndrome in patients who were selected for arthroscopic subacromial decompression. The effectiveness of this procedure and rate of recovery after surgery were also assessed to identify factors which influence the outcome. J Bone Joint Surg PATIENTS AND METHODSWe have used arthroscopic subacromial decompression since 1989 for chronic rotator-cuff impingement. As the technical demands of this procedure need time to be acquired this study was started after experience of two-anda-half years.We defined rotator-cuff impingement as inflammatory changes in the rotator cuff and the overlying subacromial bursa which had produced shoulder pain with loss of function and increased pain on elevation of the arm above shoulder level. This may develop after injury or overuse; a very similar clinical picture can arise due to a calcific deposit in the substance of the tendon.We treated 49 patients with chronic rotator-cuff impingement after the failure of a minimum of six mont...

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mentioning

confidence: 99%

Treatment of Chronic Rotator-Cuff Impingement by Arthroscopic Subacromial Decompression

Nutton

McBirnie

Phillips

1997

The Journal of Bone and Joint Surgery. British volume

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“…Numerous shoulder joint injuries have been reported in association with specific sports, especially those involving throwing, pitching, and repetitive overhead activities [12][13][14][15][16][17]. These studies indicate that the resultant pathologies are either associated with the manner the shoulder is used during that sport or with a specific mechanism of injury.…”

Section: Slap: Superior Labrum Anterior Posterior Lesion As: Anteriomentioning

confidence: 99%

Arthroscopic shoulder assessment in Turkish amateur boxers

et al. 2009

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AbstractThe most common injuries reported in the literature regarding the sport of boxing are to the brain, eyes, kidneys and hands. Shoulder injuries have not been fully reported in the literature until recently, as a result we aimed to present our arthroscopic findings in amateur boxers. Ten amateur boxers with complaints of pain in the shoulder region and decreased performance during sportsplay were enrolled. They were evaluated by physical examination, radiology and arthroscopy. There were no clinical findings of instability. One patient was found to have subacromial impingement; six had crepitation at various degrees during shoulder movements. At arthroscopy, all patients had a variety of pathological findings. Five patients had Grade 1, three had Grade 2, and two had Grade 3 chondropathy. Various degrees of fraying of the anterosuperior and posterosuperior regions of the glenoid labrum were noted in all cases. Three patients had superior labrum anterior and posterior lesions, one patient had a posterior labroligamentous lesion, and one had chondral erosion in the anterosuperior portion of the humeral head. In conclusions, although the injury mechanism of the shoulder during boxing is unknown, this study shows that shoulder complaints in boxers should be considered as possible indicators of serious intra-articular lesions.

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“…Penny and Welsh (25) emphasize the importance of the avascular zone and add that repeated microtrauma in the area results in an inflammatory response with edema and an increase in the volume of the tendinous structure. Heterotopic calcification occurring in the area also increases the volume, leaving less clearance for the soft tissues in the area to pass beneath the acromion.…”

Section: Mechanical Versus Vascular Modelsmentioning

confidence: 99%

“…Ice application by ice cup, ice pack, or refreezable gel packs is advocated by Richardson (28), Johnson et al (1 4), Cuillo (2), and Penny and Welsh (25). Hawkins and Abrams (8) recommend icing the part for 10 minutes following workout.…”

Section: Treatment Of Stage Imentioning

confidence: 99%