Arthroscopic superomedial scapulectomy for symptomatic snapping scapular: Surgical technique

Dr. Tananthorn Piamthipmanas
Dr. Wasaphon Suphakitchanusan
Dr. Ekavit Keyurapan

AOSMAK volume 1 (2022)

Archives of Orthopedic Sports Medicine and Arthroscopy Knowledge (AOSMAK) is an open-access peer-reviewed journal of Thai Orthopaedic Society for Sports Medicine (TOSSM)

Piamthipmanas T, MD, Suphakitchanusan W, MD, Keyurapan E, MD
Department of Orthopedics, Faculty of Medicine, Siriraj hospital

Background: Scapulothoracic bursitis and prominent of the superomedial angle of the scapula, known as the Luschka tubercle, were the causes of symptoms in patients with symptomatic snapping scapular. Arthroscopic superomedial scapulectomy with bursectomy is an optional treatment in patients who fail nonsurgical modalities.
Description of technique: The procedure was performed with the patient in the prone position with the surgical side prepared in the chicken-wing position. The surgeon will stand on the contralateral side, with the assistant standing distal to the surgeon. The arthroscopic towers stand at the level of the patient’s thorax across the surgeon. The initial portal was created at the inferior scapula and placed towards the scapulothoracic space. The spinal needle was used to guide the superior scapula portal as a working portal. The superomedial angle of the scapula was identified by release of the muscular attachments. The Luschka’s tubercle was distinguished in this region and removed using a high-speed bur.
Results: After an operation, the surgical site was immobilized in a sling for resting the adjacent muscles. The snapping sensation and dull-ache symptoms at his shoulder were diminished at the first post-operative day and 2 weeks follow-up period.
Conclusion: Arthroscopic in the prone position, with the surgical site placed in chicken-wing position using the two-portal technique, effectively treats symptomatic snapping scapular syndrome.