Ultrasound-guided subscapular local anesthetic and cortisone injection before arthroscopic superior medial scapuloplasty can improve outcomes for patients with snapping scapular syndrome, new research shows.
In the study, “Prognosis After Arthroscopic Superior Medial Scapuloplasty for Snapping Scapula Syndrome Improves After a Transient Beneficial Response With an Ultrasound-Guided Subscapular Cortisone Injection,” published in the December 2020 issue of the journal Arthroscopy, the authors evaluated 47 patients who underwent arthroscopic superior medial scapuloplasty for snapping scapula syndrome between January 2009 and December 2016.
All of the patients had failed a structured physical therapy program and had either a good response or no to minimal response to the preoperative cortisone injection. Thirty-one of the patients had a good response to the injection and 11 patients had no to little response.
Before the surgery and at the final follow-up about two years later the researchers used QuickDASH, Constant and Visual Analog Scale (VAS) scores to assess pain and functionality.
According to the data collected, there was a significant improvement after surgery in the mean QuickDASH score (from 39 to 20; p < .001) (minimal clinically important difference [MCID] 15.91), Constant score (from 57 to 87; p < .001) (MCID 10.4), and VAS (from 6 to 2; p < .001) (MCID 3).
While both groups saw improvements in scores, the good response group had markedly better scores than the no to minimal response group. (p < .05).
The study authors wrote, “The results of this study suggest that arthroscopic scapuloplasty can lead to a significant improvement in pain and function in all patients with a clinical diagnosis of snapping scapula syndrome refractory to conservative treatment. Patients who gained a good transient response to a preoperative ultrasound-guided subscapular cortisone injection obtained a significantly better recovery than those who did not. A preoperative ultrasound-guided subscapular cortisone injection appeared to be of prognostic value.”