|►Rotator cuff tear|
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|►Advice sheet on injection|
|►Advice sheet on decompression|
|►Advice sheet on stabilization|
|►Advice sheet on cuff repair|
Subacromial decompression is an operation that is indicated for patients with impingement who have not responded to other non-operative treatments; it may also be indicated in certain patients who have a rotator cuff tear. In general terms the operation is successful in the majority of cases, with 85% of all patients reporting considerable benefit. However convalescence is often quite slow, with recovery often taking 3 to 6 months.
The operation is now normally undertaken arthroscopically (i.e. by keyhole surgery) although there are sometimes occasions when it is done through a conventional surgical incision, such as when the rotator cuff is being repaired. Surgery is done under general anaesthesia and in addition a block may be used that will result in loss of sensation and paralysis of the arm for about 8 hours. In the case of an arthroscopic decompression there will be a 5mm incision behind the shoulder and 1 or 2 other incisions at the side and front of the joint. When done as an open procedure there will be a 3 - 4 cm incision on the top of the shoulder. During the procedure part of the underside of the acromium (part of the shoulder blade) along with the coraco-acromial ligament will be removed; it is these structures that cause pressure and impingement on the rotator cuff. In addition other procedures such as excision of calcific deposits or repair of the cuff may be undertaken.
You can expect increased pain in your shoulder for several weeks after surgery. However in the case of a simple decompression your arm will not be in a sling and you will be encouraged to move it as much as possible. Most patients find that they are able to drive within 1 to 2 weeks and are then able to return to work. If you have a manual job you will probably have to htake about 6 weeks of leave. Steady improvement in symptoms is then seen with most patients being pain free within 3 to 6 months.
As with any operation this procedure is not complication free. The main risks are:
- Failure to relieve pain About 15% patients will not respond to surgery. Most of these patients report that their pain is unaltered, although a few will develop worse pain
- Infection Infection following arthroscopy is rare but can occur
- Stiffness Any operation on a joint may result in stiffness, although this is very rare following arthroscopic decompression
- Nerve and vessel damage This is extremely rare
For a full summary of information regarding subacromial decompression, please read the Surgical Advice Sheet
|© J M Britton 2007|