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Scapulothoracic arthroscopy for symptomatic snapping scapula: a prospective cohort study with two-year mean follow-up

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Abstract

Background

Snapping scapula is characterized by crepitus between the scapula and the chest wall due to abnormal tissue at this site. Surgical treatment, when needed, may be either open or arthroscopic. The aim of this study was to evaluate prospectively the clinical outcomes of arthroscopic decompression in ten subjects with symptomatic snapping scapula.

Patients and methods

Ten subjects, five men and five women, mean age 24 years, were treated by arthroscopy after unsuccessful conservative management for 6 months. Clinical outcomes were evaluated with the Western Ontario Rotator Cuff (WORC) index, Constant–Murley score (CS), and simple shoulder test (SST). Follow-up was at 3 and 6 months; the final evaluation was conducted at a mean interval of 24 months. The final and preoperative X-rays were compared.

Results

The WORC index increased significantly at 3 (p < 0.05), 6 (p < 0.01), and 24 months (p < 0.01). Similar outcomes were found for the CS at all 3 follow-up points (3 months, p < 0.05; 6 months, p < 0.01; 24 months, p < 0.01). Mean “yes” responses on the SST were 9.8 ± 1.4 at 3 months (p < 0.05), 10.2 ± 1.2 at 6 months (p < 0.01), and 10.6 ± 1.2 at 24 months (p < 0.01). X-ray examination depicted flattening of the anterior surface of the superior-medial angle of the scapula in the five patients who had had bone resection, whereas no significant difference with preoperative imaging was detected in the five patients who were managed by bursectomy and debridement alone.

Conclusions

Arthroscopy is a feasible and minimally invasive treatment for painful snapping scapula syndrome. Comparative clinical trials are needed to collect conclusive data to state that it is the most suitable treatment for this condition.

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Conflict of interest

Giovanni Merolla, Simone Cerciello, Paolo Paladini, Giuseppe Porcellini declare that they have no conflict of interest.

Ethical standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and National) and with the Helsinki Declaration of 1975, as revised in 2000 (5). All patients/subjects provided written informed consent to enrollment in the study and to the inclusion in this article of information that could potentially lead to their identification. The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

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Authors and Affiliations

  1. Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Cattolica, Italy

    G. Merolla, S. Cerciello, P. Paladini & G. Porcellini

  2. Biomechanics Laboratory “Marco Simoncelli”, D. Cervesi Hospital, Cattolica, Italy

    G. Merolla

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  1. G. Merolla
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  2. S. Cerciello
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  3. P. Paladini
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  4. G. Porcellini
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Correspondence to G. Merolla.

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Merolla, G., Cerciello, S., Paladini, P. et al. Scapulothoracic arthroscopy for symptomatic snapping scapula: a prospective cohort study with two-year mean follow-up. Musculoskelet Surg 98 (Suppl 1), 41–47 (2014). https://doi.org/10.1007/s12306-014-0316-1

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