What Is Subacromial Decompression?
Subacromial decompression is a surgical treatment that addresses a common cause of shoulder pain: subacromial impingement, also known as shoulder impingement.
The shoulder is one of the most complex joints in the body. It is a meeting of three bones: the humerus (upper arm), the clavicle (collarbone) and the scapula (shoulder blade). Holding it together is a group of muscles and tendons called the rotator cuff.
There is a bony structure on top of the scapula (shoulder blade) called the acromion process. That’s what “subacromial” means: under the acromion process. When the arm is raised, the space between the rotator cuff and acromion gets smaller, and the acromion can rub against tissues of the rotator cuff and the fluid-filled sac (bursa) that lubricates the shoulder. This painful condition is called impingement. It can lead to loss of strength and range of motion, making everyday movements more difficult.
Subacromial decompression aims to make more room in the shoulder by either shaving down the acromion, removing bone spurs or both. It can be done arthroscopically or with a larger incision. The surgeon may also repair damaged rotator cuff tissue at the same time.
Common Reasons for Subacromial Decompression
Subacromial decompression is a treatment for subacromial impingement. Subacromial impingement can be caused by repetitive overhead movements, such as those performed by painters, shelf stockers and weightlifters. Weak shoulder muscles and loose ligaments are often seen with such overuse, which further puts a person at risk for subacromial impingement. Finally, some people are born with a smaller subacromial space, making impingement more likely—especially if that person also makes repetitive overhead movements.
Candidates for Subacromial Decompression
Candidates for subacromial decompression are people diagnosed with subacromial impingement for whom more conservative treatments have not proven effective. These treatments can include:
The Subacromial Decompression Procedure
Subacromial decompression can be performed either arthroscopically or as an open surgery. An arthroscopic surgery involves small incisions, small tools and a flexible camera known as an arthroscope attached to a video monitor. Open surgery requires a larger incision so that the surgeon can see the acromion without a camera and monitor.
To create more space for the rotator cuff tendons and the bursa, the acromion will be shaved down. Sometimes, the injured portion of the bursa or a tendon will be removed at the same time.
Recovery from Subacromial Decompression
Subacromial decompression is usually an outpatient surgery, meaning no hospital stay is necessary. Because the incisions are smaller, arthroscopic subacromial decompression usually has a shorter recovery time than open subacromial decompression.
Physical therapy will likely be recommended after the surgery. This is to strengthen the muscles of the shoulder and restore range of motion. Most people recover from the surgery in three to six months.
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