Acromioplasty is a surgical procedure to treat impingement of the shoulder and disease of the rotator cuff. This involves removing the acromion from a small piece of bone and soft tissue.
In this article, we look at why acromioplasty may be required by people and what it involves, as well as the recovery, benefits and complications.
What is acromioplasty?
Acromioplasty is a surgical procedure involving the acromion called shaving away part of the shoulder bone.
Surgeons perform the procedure to relieve rotator cuff tendon impingement which supports and strengthens the shoulder joint.
Acromioplasty is also known as decompression subacromiale.
Why undergo acromioplasty?
A doctor can recommend acromioplasty as a treatment option for individuals experiencing shoulder pain, particularly with overhead operation, and decreased shoulder or arm strength. Some of these people may also have trouble reaching the arm behind the body to do a zipper for example.
Those symptoms can occur because of the following conditions:
The four rotator cuff muscles cover a person’s shoulder and protect it.
One of the tendons that attaches these muscles to the top of the arm bone may get pinched between the two bones, resulting in impingement of the shoulder. In this area, a person will feel pain, particularly when they raise their arm sideways and above shoulder height.
There are multiple possible causes of impingement including:
- doing a job or sports activity that requires lifting the arm in overhead positions
- as a person ages, the underside of the acromion may develop bone spurs that narrow the space between the bones of the shoulder
- overuse of the tendons from sports may cause them to become swollen or torn
Rotator cuff tears
Because of injury the tendons in the rotator cuff may get torn or this damage may develop over time.
Both surgical and non-operative treatments are available to treat rotator cuff tears. The preferred surgical procedure varies from surgeon to surgeon, according to an article in the World Journal of Orthopaedics.
A 2018 review suggested that using acromioplasty alongside rotator cuff repair did not lead to significant clinical improvements in function and pain in the shoulder.
What is the procedure?
The operation is carried out under general anesthetic by an orthopedic surgeon.
By extracting some of the bone, usually from its underside, the surgeon aims to make more room under the acromion.
Normally, they may perform keyhole surgery (arthroscopy), which involves inserting a thin, tube-like camera called an arthroscope through a small cut into the skin.
The surgeon uses the arthroscope to look inside the shoulder and then use special surgical instruments to carry out the procedure.
The surgeon takes a look at the tendons of the rNo otator cuff. If these have been broken, they will be replaced by the surgeon so the person is not required to undergo a second surgery.
The surgeon can sometimes need to make a larger incision to do this. Most often, however, the entire operation is conducted arthroscopically through the small keyhole incisions.
The person will typically wear a sling to support the arm after the surgery. The length of time people need to use the sling varies enormously, so a person can ask the surgeon for their advice.
Patients may also take anti-inflammatory drugs such as ibuprofen or use an ice pack to relieve pain after the surgery.
Many people participate in a rehabilitation program after surgery, which could include support from a physiotherapist. This specialist can tell the person what workouts they can do at home to regain strength and mobility.
A health care professional may provide advice on when returning to work is safe.
Risks and complications
Infection may be a risk after surgery.
Signs of infection include:
- the wound being hot, red, or swollen
- bleeding or drainage from the incisions
- worsening pain
- a high temperature
Anyone who is considering having acromioplasty should discuss the potential risks and complications with their surgeon or doctor.
Some of the possible complications include:
- nerve damage
- damage to blood vessels
- stiffness or “frozen shoulder”
- anesthesia complications
Acromioplasty may be an effective treatment for someone with an impingement on the neck. Sometimes, surgeons perform this operation as they perform surgery for a tear of the rotator cuff.
A person may seek treatment options from a doctor for their illness. Often, the doctor may address certain factors, such as risks, complications and how the disorder affects the life of the person.
Certain aspects to consider include recovery time, any assistance that the person may need during recovery and what rehabilitation may involve.
A person will need to weigh these against their current quality of life to help them decide if surgical or non-operative treatments are likely to be best for them.