Subacromial Decompression

Subacromial decompression (acromioplasty) is an operation on your shoulder. It is used to treat a condition called shoulder impingement. This is when the bones and tendons in your shoulder rub against each other when you raise your arm, causing pain.

If you are having a subacromial decompression procedure it will probably be done through keyhole surgery (arthroscopy) under general anaesthesia.

What is Shoulder Impingement?

If you have shoulder impingement, a bone at the top of your shoulder rubs against the tendons in your shoulder when you raise your arm. This causes pain when you try to raise your arm, and restricts your movement.

There’s normally a space between the top of your arm bone and the bone at the top of your shoulder blade, called the subacromial area. A small, fluid-filled sac (bursa) in this space allows the tendons between your upper arm and shoulder to glide freely when you move your arm.

In subacromial impingement, the amount of space between your shoulder blade and rotator cuff tendons is reduced. This may be due to irritation and swelling of the bursa. It can also be caused by the development of growths (bony spurs) on the top of your shoulder blade.

Subacromial decompression can open up this space by removing any swollen or inflamed bursa, and any bony spurs.

What are the Alternatives to Subacromial Decompression?

Shoulder pain has various causes and the symptoms can often be managed with other options such as:

Physiotherapy
Steroid joint injections

The orthopaedic surgeon will usually only recommend you to have subacromial decompression if non-surgical treatments is not working for you.

What happens during Subacromial Decompression?

Subacromial decompression can take around an hour, depending on how complicated your operation is. The operation is usually done as a keyhole procedure.

Subacromial decompression is usually done under general anaesthesia, which means that you’ll be asleep during the procedure. Once the anaesthetic has taken effect, your surgeon will make small cut in the skin around your shoulder.

Your surgeon will look into the area called the subacromial space within your shoulder. This will be either directly through the arthroscope, or at pictures sent from the arthroscope to a monitor. They will insert specially designed surgical instruments through the small cuts and reshape this part of your shoulder blade. Your surgeon may also decide to repair any damaged tendons at the same time.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed.

You will usually be able to go home when you feel ready.

Before you leave hospital your nurse will give you advice about caring for your wounds, and what to do about any stitches you have. You may need to keep your arm in a sling for a few days after your operation.

Recovering from subacromial decompression

You may see a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) after your operation. It’s really important that you do any exercises that your physiotherapist or surgeon recommends. These may help you to recover more quickly. Your surgeon or physiotherapist will tell you when to start these exercises, and how many to do.