Shoulder Impingement and its Association with Acromial Morphology- A Review
Dr. Rashmi C Goshi,
Assistant Professor, Department of Anatomy, JSS Medical College, Mysuru-570015, Karnataka, India.
Shoulder with its chronic disability recognized by impingement of the rotator cuff beneath the coracoacromial arch. Varying acromial morphology revealed alterations attributable to mechanical impingement. The undersurface of the anterior part of the acromion and the front lip were always implicated. Extrinsic factors caused impingement and tendonopathy, with the antero-lateral acromion 'impinging' on the superior surface of the rotator cuff. The present review clearly describes the acromial morphology and its role as extrinsic causative factor in shoulder impingement. Treatment options for confirmed impingement range from analgesics and physiotherapy to injectable therapy and, open and arthroscopic surgery. In most studies, the results of arthroscopic subacromial decompression are positive, and data suggest that, the operation minimises the occurrence of rotator cuff injuries when compared to a control group. Complete acromionectomy and lateral acromionectomy yielded dismal results, prompting researchers to investigate the undersurface of the acromion in the development of impingement syndrome. There are however contradictory studies discussing the role of extrinsic and intrinsic causative factors of impingement.