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Definition and Classification of Different Forms of Impingement

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Rotator Cuff Across the Life Span

Abstract

Since Neer’s report of impingement syndrome, various forms of impingement have been reported in the literature. They are categorized into three groups: (1) subacromial impingement, (2) posterosuperior impingement, and (3) anterior impingement. The subacromial impingement is the classic type of impingement. The word “subacromial impingement syndrome” covers wide spectrum of rotator cuff pathologies and sometimes used synonymously with shoulder pain. Due to this vague definition, various pathologies are included under the diagnostic label of impingement syndrome. As a result, outcome of surgical treatment such as acromioplasty is controversial. We need further long-term studies to clarify the efficacy of acromioplasty, especially paying more attention to the pathology of the acromion and the rotator cuff tendon. The posterosuperior impingement is found specifically in throwing athletes. This pathology and treatment are described in detail in other chapters. The anterior impingement includes various types of impingement that occur around the anterior shoulder. The most common type is the subcoracoid impingement. However, the pathoanatomy and pathophysiology of this impingement is not clearly understood such as why an articular side tear of the subscapularis occurs as a result of subcoracoid impingement. More recently, anterosuperior impingement has been reported which seems to better explain the mechanism of articular side tear of the subscapularis. We need more evidence on this specific group of anterior impingement.

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References

  1. Armstrong JR. Excision of the acromion in treatment of the supraspinatus syndrome; report of 95 excisions. J Bone Joint Surg. 1949;31b(3):436–42.

    Article  CAS  Google Scholar 

  2. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54(1):41–50.

    Article  Google Scholar 

  3. Bennett GE. Shoulder and elbow lesions distinctive of baseball players. Ann Surg. 1947;126(1):107–10.

    Article  CAS  Google Scholar 

  4. Andrews JR, Broussard TS, Carson WG. Arthroscopy of the shoulder in the management of partial tears of the rotator cuff: a preliminary report. Arthroscopy. 1985;1(2):117–22.

    Article  CAS  Google Scholar 

  5. Jobe FW, Kvitne RS, Giangarra CE. Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement. Orthop Rev. 1989;18(9):963–75.

    CAS  PubMed  Google Scholar 

  6. Walch G, Boileau P, Noel E, Donell ST. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg. 1992;1(5):238–45.

    Article  CAS  Google Scholar 

  7. Garving C, Jakob S, Bauer I, Nadjar R, Brunner UH. Impingement syndrome of the shoulder. Dtsch Arztebl Int. 2017;114(45):765–76.

    PubMed  PubMed Central  Google Scholar 

  8. McLaughlin HL. Lesions of the musculotendinous cuff of the shoulder. The exposure and treatment of tears with retraction. Clin Orthop Relat Res. 1944;1994(304):3–9.

    Google Scholar 

  9. Neer CS 2nd. Impingement lesions. Clin Orthop Relat Res. 1983;(173):70–7.

    Google Scholar 

  10. Neer CS 2nd, Welsh RP. The shoulder in sports. Orthop Clin North Am. 1977;8(3):583–91.

    PubMed  Google Scholar 

  11. Ellman H. Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy. 1987;3(3):173–81.

    Article  CAS  Google Scholar 

  12. Roye RP, Grana WA, Yates CK. Arthroscopic subacromial decompression: two- to seven-year follow-up. Arthroscopy. 1995;11(3):301–6.

    Article  CAS  Google Scholar 

  13. Hultenheim Klintberg I, Karlsson J, Svantesson U. Health-related quality of life, patient satisfaction, and physical activity 8-11 years after arthroscopic subacromial decompression. J Shoulder Elbow Surg. 2011;20(4):598–608.

    Article  Google Scholar 

  14. Farfaras S, Sernert N, Rostgard Christensen L, Hallstrom EK, Kartus JT. Subacromial decompression yields a better clinical outcome than therapy alone: a prospective randomized study of patients with a minimum 10-year follow-up. Am J Sports Med. 2018;46(6):1397–407.

    Article  Google Scholar 

  15. Vitale MA, Arons RR, Hurwitz S, Ahmad CS, Levine WN. The rising incidence of acromioplasty. J Bone Joint Surg Am. 2010;92(9):1842–50.

    Article  Google Scholar 

  16. Judge A, Murphy RJ, Maxwell R, Arden NK, Carr AJ. Temporal trends and geographical variation in the use of subacromial decompression and rotator cuff repair of the shoulder in England. Bone Joint J. 2014;96-b(1):70–4.

    Article  CAS  Google Scholar 

  17. Papadonikolakis A, McKenna M, Warme W, Martin BI, Matsen FA 3rd. Published evidence relevant to the diagnosis of impingement syndrome of the shoulder. J Bone Joint Surg Am. 2011;93(19):1827–32.

    Article  Google Scholar 

  18. Braman JP, Zhao KD, Lawrence RL, Harrison AK, Ludewig PM. Shoulder impingement revisited: evolution of diagnostic understanding in orthopedic surgery and physical therapy. Med Biol Eng Comput. 2014;52(3):211–9.

    Article  Google Scholar 

  19. Funk L, Levy O, Even T, Copeland SA. Subacromial plica as a cause of impingement in the shoulder. J Shoulder Elbow Surg. 2006;15(6):697–700.

    Article  Google Scholar 

  20. Milano G, Grasso A, Salvatore M, Zarelli D, Deriu L, Fabbriciani C. Arthroscopic rotator cuff repair with and without subacromial decompression: a prospective randomized study. Arthroscopy. 2007;23(1):81–8.

    Article  Google Scholar 

  21. Chahal J, Mall N, MacDonald PB, Van Thiel G, Cole BJ, Romeo AA, et al. The role of subacromial decompression in patients undergoing arthroscopic repair of full-thickness tears of the rotator cuff: a systematic review and meta-analysis. Arthroscopy. 2012;28(5):720–7.

    Article  Google Scholar 

  22. Abrams GD, Gupta AK, Hussey KE, Tetteh ES, Karas V, Bach BR Jr, et al. Arthroscopic repair of full-thickness rotator cuff tears with and without acromioplasty: randomized prospective trial with 2-year follow-up. Am J Sports Med. 2014;42(6):1296–303.

    Article  Google Scholar 

  23. Jobe CM. Posterior superior glenoid impingement: expanded spectrum. Arthroscopy. 1995;11(5):530–6.

    Article  CAS  Google Scholar 

  24. Gerber C, Sebesta A. Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elbow Surg. 2000;9(6):483–90.

    Article  CAS  Google Scholar 

  25. Jobe CM. Superior glenoid impingement. Orthop Clin North Am. 1997;28(2):137–43.

    Article  CAS  Google Scholar 

  26. Cunningham G, Ladermann A. Redefining anterior shoulder impingement: a literature review. Int Orthop. 2018;42(2):359–66.

    Article  Google Scholar 

  27. Goldthwait JE. An anatomic and mechanical study of the shoulder-joint, explaining many of the cases of painful shoulder, many of the recurrent dislocations and many of the cases of brachial neuralgias or neuritis. Am J Orthop Surg. 1909;6(4):579–606.

    Google Scholar 

  28. Gerber C, Terrier F, Ganz R. The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg. 1985;67(5):703–8.

    Article  CAS  Google Scholar 

  29. Gerber C, Terrier F, Zehnder R, Ganz R. The subcoracoid space. An anatomic study. Clin Orthop Relat Res. 1987;(215):132–8.

    Google Scholar 

  30. Lo IK, Burkhart SS. The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy. 2003;19(10):1142–50.

    Article  Google Scholar 

  31. Friedman RJ, Bonutti PM, Genez B. Cine magnetic resonance imaging of the subcoracoid region. Orthopedics. 1998;21(5):545–8.

    CAS  PubMed  Google Scholar 

  32. Suenaga N, Minami A, Kaneda K. Postoperative subcoracoid impingement syndrome in patients with rotator cuff tear. J Shoulder Elbow Surg. 2000;9(4):275–8.

    Article  CAS  Google Scholar 

  33. Park JY, Lhee SH, Oh KS, Kim NR, Hwang JT. Is arthroscopic coracoplasty necessary in subcoracoid impingement syndrome? Arthroscopy. 2012;28(12):1766–75.

    Article  Google Scholar 

  34. Ladermann A, Chague S, Kolo FC, Charbonnier C. Kinematics of the shoulder joint in tennis players. J Sci Med Sport. 2016;19(1):56–63.

    Article  CAS  Google Scholar 

  35. Castagna A, Mouhsine E, Conti M, Vinci E, Borroni M, Giardella A, et al. Chondral print on humeral head: an indirect sign of long head biceps tendon instability. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):645–8.

    Article  Google Scholar 

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Correspondence to Eiji Itoi .

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Itoi, E., Yamamoto, N. (2019). Definition and Classification of Different Forms of Impingement. In: Imhoff, A.B., Savoie, F.H. (eds) Rotator Cuff Across the Life Span. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58729-4_10

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  • DOI: https://doi.org/10.1007/978-3-662-58729-4_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58728-7

  • Online ISBN: 978-3-662-58729-4

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