Shoulder Surgery - Adelaide Orthopaedic Specialist
A subacromial decompression may be performed to alleviate pain from shoulder impingement. Dr James McLean has undertaken specialised training to deliver this procedure with a minimally-invasive arthroscopic approach.
What is arthroscopic subacromial decompression?
Subacromial decompression is a surgical procedure used to treat shoulder impingement. It involves cutting the coracoacromial (CA) ligament and shaving away part of the acromion bone, reducing the pressure on the muscle and allowing it to heal.
Dr James McLean has undergone additional surgical training which allows him to perform subacromial decompression using an arthroscopic (keyhole) approach. This results minimal blood loss and damage to the surrounding tissues during the procedure, which may lead to less pain post-procedure and reduced recovery times.
When is arthroscopic subacromial decompression performed?
Subacromial decompression may be used to treat shoulder impingement which has not responded to conservative management techniques. If you have a diagnosis of shoulder impingement and have undergone 4-6 months of conservative treatment without results, you may be a candidate for surgery.
Shoulder impingement can be caused by changes to the shape of the acromion bone. These may result from trauma, overuse, or diseases such as shoulder arthritis. It’s usually diagnosed via shoulder arthroscopy.
What happens in an arthroscopic subacromial decompression?
Arthroscopic subacromial decompression takes place under a general anaesthetic. A small incision is made in the shoulder to allow access for the arthroscope, which Dr James McLean uses to inspect the surgical site from the inside. He confirms the diagnosis and determines the most appropriate approach.
Once appropriate action is determined, other small incisions are made to allow access for small surgical instruments. These are used to shave away part of the acromion bone and cut or remove the CA ligament, making more room for the tendons in the rotator cuff to move freely.
After the procedure is complete, the tools are retracted and the incisions are closed with stitches or surgical tape.
What are the risks involved?
As with any surgical procedure, arthroscopic subacromial decompression carries potential risks. These include:
- Anaesthesia risks
- Frozen shoulder
- Damage to blood vessels and nerves
- Ongoing pain after the procedure
- Failure to alleviate symptoms, potentially requiring revision surgery.
What to expect after arthroscopic subacromial decompression
Immediately after the procedure, your wound sites will be covered with dressings and your arm will be placed in a sling for comfort. These can usually be removed within 48 hours. You can generally begin moving your shoulder as soon as pain permits.
You will be discharged from the hospital with individualised instructions from your medical team, and prescriptions for any medications you require. You may be advised to begin post-operative exercises under the guidance of your surgeon.
About two weeks after your procedure, you’ll be scheduled for a follow-up appointment with Dr James McLean. This appointment will include a physical exam to check your healing progress and guidance on your return to normal activity. It’s important to mention any concerns you have about your recovery at this appointment.
Generally speaking, you can resume normal activities within a few weeks of your subacromial decompression under the guidance of your physiotherapist and orthopaedic surgeon.