20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

SUBACROMIAL IMPINGEMENT/BUSITIS

Subacromial impingement/bursitis refers to a condition in which the rotator cuff tendons are pinched between the humeral head and the acromion process of the shoulder blade. The bursa is a fluid filled sac located between the rotator cuff tendons and the acromion process. The intermittent pinching may lead to inflammation and/or partial tearing of the rotator cuff tendons. The bursa also become inflamed and irritated with pinching; this condition is called “bursitis.” Over time, some patients may develop bone spurs on the bottom of the acromion process, which may lead to more severe symptoms.

Symptoms

  • Sharp pain on the front and outside of the shoulder with overhead activity
  • Shoulder weakness due to pain

Diagnosis And Treatment

Dr. Keller considers each patient’s symptoms, as well as a detailed physical examination and x-rays to make the diagnosis of outlet impingement. Dr. Keller may also consider an MRI to evaluate the rotator cuff. Most patients with impingement can be treated successfully without surgery with a dedicated physical therapy program. Physical therapy focuses on restoring the natural mechanics of the shoulder, with particular emphasis paid on posture and strengthening certain muscles around the shoulder blade. Other non-surgical treatment options include a course of anti-inflammatory medications, activity modification, as well as injections. The most common type of injection that Dr. Keller recommends is a steroid injection. A steroid is a powerful anti-inflammatory medication that can significantly reduce pain. In those patients with severe impingement/bursitis who do not recover with the above-mentioned treatment options, Dr. Keller may recommend surgery.

During surgery, Dr. Keller uses a minimally invasive, arthroscopic approach to remove the inflamed bursal tissue and any bone spurs on the undersurface of the acromion process. Dr. Keller also carefully visualizes the rotator cuff. In those patients with significant injury to the rotator cuff, Dr. Keller may clean the edges of the rotator cuff tissue or repair the tissue if it is torn extensively.