SUBACROMIAL DECOMPRESSION AND ACROMIOPLASTY
Subacromial impingement/bursitis refers to a condition in which the rotator cuff tendons and bursa (a fluid-filled sac) are pinched between the humeral head and the acromion process of the shoulder blade. The intermittent pinching may lead to inflammation and/or partial tearing of the rotator cuff tendons. Over time, some patients may develop bone spurs on the bottom of the acromion process, which may lead to more severe symptoms.
In those patients who require surgery, Dr. Welch performs a subacromial decompression and acromioplasty using a minimally-invasive, arthroscopic technique. Dr. Welch positions small, motorized arthroscopic instruments in the space above the rotator cuff and removes the inflamed bursal tissue. In those patients with an acromion process that is hooked and “impinging” on the rotator cuff, Dr. Welch will flatten the acromion process – “acromioplasty.” In those patients with a bone spur on the undersurface of the acromion process, Dr. Welch will also perform an acromioplasty. Some patients may also have bone spurs at the junction between the clavicle (collarbone) and acromion process. For these patients, Dr. Welch will remove the bone spurs and flatten the end of the clavicle bone.
Following surgery, patients are given a sling for comfort. Dr. Welch recommends intermittent icing and gentle range of motion following surgery. Dr. Welch also recommends starting physical therapy approximately two weeks after surgery. Physical therapy focuses on reducing swelling in the shoulder, restoring full range of motion, and maintaining strength in the shoulder. Patients should expect to regain their motion within 6-8 weeks of surgery and should have normal or near-normal function within two months.