Abstract

Bei einem posterosuperioren Impingement kann eine Insuffizienz der ventralen Kapsel mit einer arthroskopischen Kapselplastik korrigiert werden. Ein subakromiales Impingement darf nur dann mit einer Akromioplastik behandelt werden, falls alle alternativen Ursachen der Beschwerden ausgeschlossen sind. Bei Intervall-Läsionen der Rotatorenmanschette muss die Instabilität der langen Bizepssehne beseitigt werden. Am AC-Gelenk werden höhergradige Sprengungen operativ behandelt, degenerative Arthrosen mit einer arthroskopischen AC-Resektion. Verf.-Referat

Abstract

In case of high level athletes the surgical treatment of injuries and overuse syndromes of the shoulder has to meet high expectations. These can only be fulfilled if the indication for the procedure is accurate. In case of a posterosuperior impingement an insufficiency of the anterior capsule may be addressed by an arthroscopic capsular plication.This procedure is also appropriate for a posterior instability of the shoulder. Subacromial impingement syndromes may only be treated by an acromioplasty, if all alternative causes of the complaints are excluded. In case of interval lesions of the rotator cuff, the instability of the long biceps tendon must be eliminated. At the AC joint dislocations of Rockwood type III to VI are reconstructed surgically, whereas a degenerative arthritis is treated by an arthroscopic AC resection. Because of its complex anatomical structure the shoulder does not forgive any procedure that does not accurately address the pathology. Verf.-Referat