الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Subacromial impingement syndrome is a specific diagnosis and is not the only cause of pain in the anterosuperior aspect of the shoulder. It is important to differentiate subacromial impingement syndrome from ACJ pathology,other shoulder causes(arthritis,tendinitis,capsulitis) and other remote causes nerve compression.
Arthroscopic subacromial decompression is effective in relieving the symptoms of rotator cuff tendinitis. the procedure is usually technically easy and safe. The goal of surgery is not to flatten or shorten the acromion, but simply to remove any prominence to the anteroinferior or lateral undersurface.
Ellman(1987) published his initial results using the technique, arthroscopic acromioplasty has become one of the most commonly performed procedures in orthopedics. Since the original description, however, there has been an ongoing debate as to the surgical indications, the best technique, and the appropriate amount of bone to resect.(4)
This study was conducted to assess the results of treating subacromial impingement with or without AC joint problem using arthroscopic decompression and assess the advantages and disadvantages of this technique.
Twenty patients are included in this study. All of them have been subjected to history taking, detailed physical examination and different radiological examination including plain x rays, Ultrasonography,CT arthrogram and MRI. All of them received an adequate course of conservative treatment before they are subjected to arthroscopic treatment at least for 6 monthes.
In this current study differente impingement pathology as due to shape of acromion ,AC arthrosis and acrmial spur so it requires individual planning. Decisions regarding additional portals.
In this current study the arthroscopy in the lateral decubitus position under general anesthesia. We utilize from 3 to 5 portals: posterior, anterior, lateral, antrolateral and postrolateral portals for this operation. We first inspect the glenohumeral joint to detect any associated pathology with special atention to biceps tendon. Then we shift the scope to the subacromial space. First we perform bursectomy Then we perform acromioplasty and resection of the coracoacromial ligament.if there is an AC arthrosis we did it throught direact approetch.