Arthroscopic Resection of the Superomedial Border of the Scapula

A video that covers the diagnosis, imaging, and technique for arthroscopic scapulothoracic bursectomy and resection of the superior medial border of the scapula. It presents the results, which reveal that the arthroscopic technique has comparable clinical outcomes, better cosmesis, and a quicker return to work and sport.

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Area of Focus: Arthroscopy and Shoulder & Upper Extremity. Snapping scapula syndrome, also known as superior medial border syndrome, is an uncommon cause of shoulder pain in the adult. Patients can be grouped by whether or not they have an anatomic lesion, such as an osteochondroma. In those patients without an anatomic lesion, an inflamed, hypertrophic scapulothoracic bursa is assumed to be the pathologic lesion. Most patients with snapping scapula syndrome can be treated non-operatively with physical therapy and injections. If an extensive course of non-operative management fails, surgery is indicated. Both open and arthroscopic techniques have been used to treat this syndrome with uniformly good results. In our series, seven patients underwent open superior-medial border resection from 2001-2004; subsequently, an additional four patients have undergone arthroscopic debridement of the superior medial border of the scapula. All procedures were performed by a single surgeon. There were no complications, and all patients returned to their previous level of work and sport. One patient in the open group had a Fair result; the remaining patients had a Good or Excellent result. This video covers the diagnosis, imaging, and technique for arthroscopic scapulothoracic bursectomy and resection of the superior medial border of the scapula. The video also presents our results, which reveal that the arthroscopic technique has comparable clinical outcomes, better cosmesis, and a quicker return to work and sport.