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Muscles of the Shoulder

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Scapulothoracic Arthroscopy for Snapping Scapula Syndrome.

Michael Nammour¹, Justin Arner¹, Ryan Murray²

¹University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Video Journal of Sports Medicine

|May 1, 2025

Summary

Snapping scapula syndrome (SSS) is a condition causing painful clicking of the shoulder. Arthroscopic surgery, including bursectomy and scapular resection, offers an effective minimally invasive treatment for persistent SSS.

Keywords:

arthroscopy periscapular scapulothoracic snapping scapula sports medicine

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Area of Science:

Orthopedic Surgery
Sports Medicine
Arthroscopy

Background:

Snapping scapula syndrome (SSS) disrupts normal scapulothoracic joint motion, causing audible clicking or snapping.
Etiologies vary, with conservative treatments being the initial approach.
Surgical intervention is considered for cases unresponsive to extensive nonoperative management.

Purpose of the Study:

To describe the arthroscopic surgical technique for treating snapping scapula syndrome.
To evaluate the efficacy of arthroscopic bursectomy and partial scapular resection.

Main Methods:

A prone patient position is utilized with the operative arm positioned posteriorly.
Two arthroscopic portals are established: a superior portal (3 cm medial to the scapular border) and an inferior portal (4 cm inferior to the superior portal).
Arthroscopic shaver, ablator, and bur are employed for bursectomy and partial resection of the superomedial scapular border.

Main Results:

Limited studies exist, but current literature indicates scapulothoracic arthroscopy effectively improves crepitus and pain.
The procedure aims to enhance clinical outcome scores in patients with SSS.

Conclusions:

Arthroscopic bursectomy and partial bony resection are effective for SSS refractory to conservative therapy.
This minimally invasive approach offers improved cosmesis and facilitates an early return to activities.
Meticulous patient positioning and portal placement are crucial to prevent iatrogenic injuries, especially to neural structures.