Arthroscopic release of the superior transverse ligament and SLAP refixation in a case of suprascapular nerve entrapment

We report a case of suprascapular nerve entrapment at the suprascapular notch combined with a type H SLAP lesion resulting in supraspinatus and infraspinatus muscle weakness and shoulder pain in a 27-year-old female professional handball player. The magnetic resonance imaging scan showed significant atrophy of the supraspinatus and infraspinatus muscles. Electromyography revealed an isolated proximal lesion of the suprascapular nerve. The patient was treated by an arthroscopic release of the superior transverse ligament and repair of the type H SLAP lesion. Follow-up evaluations were performed 6 weeks, 3 months, and 6 months postoperatively. The Constant score improved from 51 to 84 points. Electromyography studies 3 and 6 months after surgery showed significant improvement with normal reinnervation of the supraspinatus and infraspinatus muscles. To our knowledge, this is the first report of proximal suprascapular nerve entrapment with coincidence of a SLAP lesion that was treated arthroscoipically. On the basis of this case, we found that arthroscopic release of the superior transverse ligament is an effective procedure for decompression of the suprascapular nerve. Although it is a technically demanding procedure, the arthroscopic approach has the advantage of detecting concomitant lesions such as SLAP lesions.