Indications for operation
Subacromial Impingement (painful arc) unresponsive to treatmentRotator cuff rupture (repaired at same time)Acromioclavicular
Joint (ACJ) arthritis (treated at same time)
Anaesthetic
General anaesthetic with an interscalene block – you will be asleep and the interscalene block make the arm ‘go dead’ so when you wake the pain should be
minimal
Incisions
5mm incisions will be made in the shoulder to place instruments around the shoulder to examine all areas of the shoulder. The number of incisions depends on the type of procedure performed
Procedure
The gleno-humeral (shoulder) joint will be inspected first followed by the subacromial bursa and the rotator cuff. Using arthroscopic instruments soft
tissue and bone will be removed to allow the tendons more room to move. This may be combined with excision of the outer aspect of the clavicle if this is
pressing on the rotator cuff.
Wound closure
Absorbable sutures are placed in the wounds just under the skin, combined with butterfly (paper) sutures. There are no sutures to be removed. Dressings: Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.
Immediate aftercare
A sling will be placed on the arm and it may feel numb for the rest of the day. You can go home when you feel comfortable and will be given instructions on what to do next.If no rotator cuff repair is performed then you will be encouraged to move the arm under physiotherapy guidance in 24 hours. Most patients can leave hospital the same day and feel comfortable to drive a car after about 2 weeks.Signs of improvement are usually noticed after about 4-6 weeks; however the overall recovery can take up to 9 months.
Risks associated with Subacromial Decompression
All surgical procedures have some element of risk attached. Those outlined below are the most common or most significant to be reported. Precautions are taken against all complications
Continued pain - 5%. In the majority of cases all the pain is removed by surgery however occasionally a small amount of pain persists.
Infection - Less than 0.1%. if this is superficial a short course of antibiotics may be required, if the infection is deeper in the tissues
then a washout may be required
Nerve damage - Less than 0.1%.
Stiffness - 1%. The shoulder will often become stiff after surgery and this usually settles with time and physiotherapy. Very occasionally the shoulder can
become very stiff and require further procedures.Indications for operation
Subacromial Impingement (painful arc) unresponsive to treatmentRotator cuff rupture (repaired at same time)Acromioclavicular
Joint (ACJ) arthritis (treated at same time)
Anaesthetic
General anaesthetic with an interscalene block – you will be asleep and the interscalene block make the arm ‘go dead’ so when you wake the pain should be
minimal
Incisions
5mm incisions will be made in the shoulder to place instruments around the shoulder to examine all areas of the shoulder. The number of incisions depends on the type of procedure performed
Procedure
The gleno-humeral (shoulder) joint will be inspected first followed by the subacromial bursa and the rotator cuff. Using arthroscopic instruments soft
tissue and bone will be removed to allow the tendons more room to move. This may be combined with excision of the outer aspect of the clavicle if this is
pressing on the rotator cuff.
Wound closure
Absorbable sutures are placed in the wounds just under the skin, combined with butterfly (paper) sutures. There are no sutures to be removed. Dressings: Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.
Immediate aftercare
A sling will be placed on the arm and it may feel numb for the rest of the day. You can go home when you feel comfortable and will be given instructions on what to do next.If no rotator cuff repair is performed then you will be encouraged to move the arm under physiotherapy guidance in 24 hours. Most patients can leave hospital the same day and feel comfortable to drive a car after about 2 weeks.Signs of improvement are usually noticed after about 4-6 weeks; however the overall recovery can take up to 9 months.
Risks associated with Subacromial Decompression
All surgical procedures have some element of risk attached. Those outlined below are the most common or most significant to be reported. Precautions are taken against all complications
Continued pain - 5%. In the majority of cases all the pain is removed by surgery however occasionally a small amount of pain persists.
Infection - Less than 0.1%. if this is superficial a short course of antibiotics may be required, if the infection is deeper in the tissues
then a washout may be required
Nerve damage - Less than 0.1%.
Stiffness - 1%. The shoulder will often become stiff after surgery and this usually settles with time and physiotherapy. Very occasionally the shoulder can
become very stiff and require further procedures.