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Held, Michael (2008): Anterosuperiores Impingement der Schulter als Folge von Pulley-Läsionen: Verletzungsmuster und arthroskopische Therapie; Eine prospektive Untersuchung.. Dissertation, LMU München: Faculty of Medicine
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Abstract

This prospective study provides follow-up results 47 months after arthroscopic treatment of anterosuperior impingement of the shoulder (ASI) with the aim to determine factors leading to ASI and to define the ideal treatment. 39 patients with arthroscopically diagnosed ASI were included in this study. In all patients an isolated or combined lesion of the pulley-system, the rotator-cuff, as well as the long head of the biceps tendon was observed. Postoperative improvement suggested a successful therapeutic approach and led to the conclusion that our hypothesis for the pathomechanism of ASI is acceptable. The development of ASI follows a certain order of events. The pulley-lesion leads to instability of the long head of the biceps tendon causing partial tears of the rotator cuff. The resulting anterior and upward migration of the humeral head finally initiates ASI. Consequently, therapeutic strategies should emphasize on restoring lesions of the pulley system and rotator cuff.