The refractory painful arc syndrome

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder and Elbow Surgery

Background:

• Painful arc syndrome often presents as severe and refractory, significantly impacting patient quality of life.
• Conservative treatments may fail for patients with persistent symptoms, necessitating surgical intervention.

Purpose of the Study:

• To evaluate the efficacy of surgical decompression for severe refractory painful arc syndrome.
• To assess pain relief and functional outcomes following clavicle excision and coracoacromial ligament division.

Main Methods:

• A cohort of twenty-three patients with severe refractory painful arc syndrome underwent surgery.
• The surgical approach involved excision of the outer clavicle and division of the coracoacromial ligament via a deltoid-splitting technique.

Main Results:

• All patients reported complete relief from night pain after a follow-up exceeding six months.
• Six patients experienced residual mild pain during movement, while the majority became symptom-free.

Conclusions:

• Surgical decompression, including clavicle resection and ligament division, is a highly effective treatment for severe painful arc syndrome.
• This surgical approach offers significant pain relief, particularly eliminating nocturnal pain, and restores function in most affected individuals.