Subacromial Decompression

Arthroscopic Subacromial Decompression
Subacromial Decompression is a surgical procedure to cure  shoulder pain due to inflammation within the shoulder joint.  These symptoms are known as “Subacromial impingement syndrome” and occurs when there is inflammation of the rotator cuff tendons and the bursa which surrounds these tendons.  This often results in pain, weakness and limited mobility and flexibility in the shoulder joint.
Symptoms and Causes of impingement syndrome:
* Pain during activities when lifting your arm above head height
* Shoulder Pain that prevents your from sleeping or wakes you at night
* Pain on the outside of your shoulder or upper arm
* Shoulder injury from sports or other physical activity that doesn’t heal on its own
* general weakness in the shoulder
* loss of full range of motion at the shoulder
Impingement occurs when the rotator cuff tendon and bursa  is squeezed or pinched between the undersurface of the acromiom  and the humeral head. (top surface of the arm bone)  Typical causes of this pinching include:
* inflammation of the tendons of the rotator cuff or bursa (often from an initial injury)
* Bone shape/structure that provides less room for the the tendons to glide freely
* Bony projections on the acromion ( Subacromial Spurs )
* osteoarthritic spurs on the acromioclavicular joint
* Calcification or thickening of the coracoacromial ligament
Surgical Intervention is generally recommended only after alternative therapies and treatments have proven ineffective.  Subacromial Decompression is generally performed on an out-patient basis and is usually considered a minor surgery.
Most of these surgeries are performed arthroscopically.   The surgeon makes several small incisions in the shoulder joint to allow him or her to insert an arthroscopic camera and check for problems that can be causing the impingement syndrome.   The surgeon may be able to discover and fix any unusual pathology found by trimming or repairing it. Anthroscopic shavers and coagulatores can be used to remove any scar tissue and clean the undersurface of the bone under the acromion. Bone spurs can be removed using an anthroscopic bur.
Complications and Risks:
It is possible for patients to develop stiffness in their shoulder joint after the procedure which can then result in pain. For this reason, the patient is encouraged to attend physical therapy after the surgery to regain full mobility of the shoulder joint as soon as possible.
Alternative Treatments:
Before trying surgery it is recommended that the patient cease and sports or physical activity that may cause further inflammation or pain in the shoulder and rest the shoulder.  Physiotherapy and anti-inflammatory medication can also have a positive effect.

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