Arthroscopic Subacromial Decompression
A procedure to relieve shoulder impingement by removing pressure from the subacromial space
Subacromial decompression involves removing or reshaping bone and soft tissue in the subacromial space of the shoulder to relieve pressure and impingement.
Common Reasons for Surgery
- Persistent pain in the shoulder due to impingement syndrome, which has not responded to conservative treatments such as physiotherapy or injections.
- Reduced range of motion or difficulty performing everyday activities.
- Inflammation or irritation of the rotator cuff tendons caused by narrowing of the subacromial space.
Goals of the Procedure:
- Relieve pain caused by shoulder impingement.
- Restore full range of motion.
- Improve function for daily activities, work, or sports.
Preparation for Surgery
Proper preparation is essential for optimal results and a smooth recovery.
Steps in Preparation:
- Pre-Surgical Consultations and Imaging:
- Dr Ben McGrath may perform physical exams and imaging, such as X-rays or MRIs, to confirm the diagnosis and plan the procedure.
- Health Optimisation:
- Achieving a healthy weight and quitting smoking can enhance surgical outcomes.
- Prehabilitation exercises may be recommended to improve shoulder strength and flexibility.
- Pre-Surgical Instructions: Follow fasting instructions and adjust medications as advised by Dr McGrath.
- Arrange for assistance post-surgery, such as transportation and support at home.
What Happens During the Surgery?
The procedure is usually performed arthroscopically, which involves small incisions and a minimally invasive approach.
Surgical Steps:
- Anaesthesia:
- General anaesthesia or regional nerve blocks are typically used to ensure comfort.
- Procedure:
- A small camera (arthroscope) is inserted into the shoulder to guide the surgeon.
- Bone spurs, inflamed tissue, or other obstructions in the subacromial space are removed or reshaped to reduce impingement.
- Completion:
- The incisions are closed with sutures or adhesive strips, and a dressing is applied.
The surgery typically takes around one hour, depending on the complexity.
Understanding the Risks
As with any surgery, subacromial decompression carries potential risks.
Common Risks:
- Temporary pain or swelling in the shoulder.
- Bruising around the surgical site.
Rare but Serious Risks:
- Damage to surrounding structures, such as nerves or blood vessels.
- Persistent pain or stiffness.
Dr McGrath will discuss these risks during your consultation and take all necessary steps to minimise them.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain management with prescribed medications.
- Use of a sling for comfort, although early mobilisation is often encouraged.
- Follow-up appointments with Dr McGrath to monitor healing.
Discharge Instructions:
- Instructions for caring for your surgical wounds.
- Guidelines on medication use and activity restrictions.
Rehabilitation and Recovery
Rehabilitation is a critical part of achieving a successful outcome after subacromial decompression surgery.
Recovery Phases:
- Early Recovery (Weeks 0–6):
- Focus on gentle movements and reducing inflammation.
- Passive and active range-of-motion exercises guided by a physiotherapist.
- Strengthening Phase (Weeks 6–12):
- Gradual introduction of strengthening exercises to rebuild shoulder stability.
- Avoid heavy lifting or strenuous activities.
- Functional Recovery (Months 3–6):
- Return to work, sports, or recreational activities as shoulder function improves.
Long-Term Outcomes
Subacromial decompression is often recommended to relieve chronic shoulder impingement symptoms and restore function.
Expected Improvements:
- Reduced pain and inflammation.
- Improved shoulder mobility and strength.
- Enhanced quality of life, allowing for a return to daily activities.
Maintaining Results:
- Commitment to physiotherapy and strengthening exercises.
- Regular follow-ups with Dr McGrath to ensure continued progress.
- Avoidance of activities that may strain the shoulder during recovery.
