Shoulder subacromial decompression (also called acromioplasty) is a surgical procedure to treat shoulder impingement, a common condition that causes weakness in your shoulder and pain when you raise your arm above your head. It is performed using keyhole surgery.
Shoulder impingement occurs when the tendons that support the rotator cuff muscles become dysfunctional and damaged.
Sometimes the shape of the bones at the top of your shoulder blade (the acromion) genetically predisposes you to irritation of the tendons. Bony spurs on the acromion can also cause damage to the tendons.
The aim of shoulder decompression surgery is to make more space under your acromion, a large bony projection on the top of shoulder blade, by removing some of the bone and tissue. It is performed under general anaesthetic as an arthroscopic procedure (keyhole surgery). A thin, flexible tube with a camera on one end called an arthroscope is inserted into a small incision in your shoulder. This allows your consultant to see inside the joint. Tiny surgical instruments are inserted through a second small incision and bone and tissue is gently removed from the underside of the acromion. If the surgeon also finds damaged tendons they may need to repair these in the same procedure (this will be discussed with you before the procedure). The incisions will be closed with sutures once the surgery is complete.
Shoulder decompression surgery is used to treat shoulder impingement syndrome, which is common in active adults, particularly as they age. It is closely related to bursitis of the shoulder, which can occur at the same time. The aim of decompression surgery is to relieve compression of the rotator cuff tendons. Arthroscopic subacromial decompression surgery is a last option procedure after all other measures of treatment including activity modification, injections, and physiotherapy have failed to relieve your symptoms.
You can normally go home once the effects of the anaesthetic have worn off although you shouldn’t drive. Your shoulder will feel sore and stiff after surgery but you can use ice and anti-inflammatories to reduce swelling. It will take around four months to recover fully from shoulder decompression surgery. You will be referred to a physiotherapist after surgery who will recommend exercises to improve movement and strengthen the muscles in your shoulder. It is important to do these exercises to relieve pain and prevent stiffness or recurrence.
This type of surgery generally produces good results, with most patients reporting a significant reduction in pain after completing a full course of physiotherapy afterwards. It is generally a safe procedure but your consultant will discuss the risks with you so you can weigh up the benefits against any possible disadvantages.
