![[Indications and techniques of arthroscopic anterior and lateral acromioplasty].](/static/images/no-image.png)
Journal article
[Indications and techniques of arthroscopic anterior and lateral acromioplasty].
- Rueckl K Lehrstuhl für Orthopädie, König-Ludwig-Haus, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Deutschland. kilian.rueckl@gmail.com.
- Ernstbrunner L Universitätsklinik Balgrist, Abteilung für Schulter- & Ellbogenchirurgie, Universität Zürich, Forchstrasse 340, 8008, Zürich, Schweiz.
- Reichel T Lehrstuhl für Orthopädie, König-Ludwig-Haus, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Deutschland.
- Bouaicha S Universitätsklinik Balgrist, Abteilung für Schulter- & Ellbogenchirurgie, Universität Zürich, Forchstrasse 340, 8008, Zürich, Schweiz.
- Barthel T Lehrstuhl für Orthopädie, König-Ludwig-Haus, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Deutschland.
- Rudert M Lehrstuhl für Orthopädie, König-Ludwig-Haus, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Deutschland.
- Plumhoff P Lehrstuhl für Orthopädie, König-Ludwig-Haus, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Deutschland.
- 2019-08-01
Published in:
- Operative Orthopadie und Traumatologie. - 2019
Acromion
Arthroscopy
Rotator cuff
Shoulder joint
Subacromial impingement
Acromion
Arthroplasty
Arthroscopy
Humans
Rotator Cuff
Rotator Cuff Injuries
Treatment Outcome
English
OBJECTIVE
Arthroscopic anterior acromioplasty (AAAP) for treatment of symptomatic subacromial spur. Arthroscopic lateral acromioplasty (ALAP) to reduce a pathological critical shoulder angle (CSA) and prevent rotator cuff re-tear after reconstruction.
INDICATIONS
AAAP is indicated for acromial impingement due to an anterolateral acromial spur with or without bursa-sided rotator cuff lesion. ALAP is indicated concomitant to arthroscopic rotator cuff repair if the CSA is pathologically increased.
RELATIVE CONTRAINDICATIONS
Irreparable rotator cuff tear with acetabularization of the acromion due to anterosuperior escape of the humeral head or symptomatic os acromiale can contraindicate for AAAP. Dehiscence of the origin of the deltoid muscle or symptomatic os acromiale can contraindicate for ALAP.
SURGICAL TECHNIQUE
To preform AAAP, arthroscopic subacromial decompression is followed by anterolateral resection of an acromion spur or ossification of the coracoacromial ligament. To perform ALAP, arthroscopic subacromial decompression and reconstruction of a rotator cuff-tear is followed by reduction of a pathologically increased CSA by resection of the lateral edge of the acromion.
POSTOPERATIVE MANAGEMENT
After isolated AAAP, physiotherapy can be performed without restriction. After AAAP or ALAP combined with rotator cuff repair, immobilization in a brace is recommended. The use of pain medication should be standardized and adapted to individual pain levels.
Arthroscopic anterior acromioplasty (AAAP) for treatment of symptomatic subacromial spur. Arthroscopic lateral acromioplasty (ALAP) to reduce a pathological critical shoulder angle (CSA) and prevent rotator cuff re-tear after reconstruction.
INDICATIONS
AAAP is indicated for acromial impingement due to an anterolateral acromial spur with or without bursa-sided rotator cuff lesion. ALAP is indicated concomitant to arthroscopic rotator cuff repair if the CSA is pathologically increased.
RELATIVE CONTRAINDICATIONS
Irreparable rotator cuff tear with acetabularization of the acromion due to anterosuperior escape of the humeral head or symptomatic os acromiale can contraindicate for AAAP. Dehiscence of the origin of the deltoid muscle or symptomatic os acromiale can contraindicate for ALAP.
SURGICAL TECHNIQUE
To preform AAAP, arthroscopic subacromial decompression is followed by anterolateral resection of an acromion spur or ossification of the coracoacromial ligament. To perform ALAP, arthroscopic subacromial decompression and reconstruction of a rotator cuff-tear is followed by reduction of a pathologically increased CSA by resection of the lateral edge of the acromion.
POSTOPERATIVE MANAGEMENT
After isolated AAAP, physiotherapy can be performed without restriction. After AAAP or ALAP combined with rotator cuff repair, immobilization in a brace is recommended. The use of pain medication should be standardized and adapted to individual pain levels.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00064-019-0620-x
- PMID 31363791
- Persistent URL
- https://folia.unifr.ch/global/documents/88534
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