Subacromial Decompression & Bursectomy
For subacromial impingement and bursitis, nonoperative modalities such as anti-inflammatory medication and injections can be extremely helpful. However, if you continue to have pain and disability despite non-operative care, then arthroscopic surgery is a reasonable option. This is outpatient surgery with an arthroscope (a camera used to look into the joint). Three small incisions are made around the shoulder to look inside the shoulder joint and in the subacromial bursa (the space above the rotator cuff). The structures in the shoulder are inspected and cleaned out as needed. The recovery and rehabilitation for this procedure is usually fairly swift, with early range of motion and then strengthening exercises. If things are going well, overhead activities can begin by 6 weeks.
Rarely, a significant partial tear of the rotator cuff is identified during arthroscopy that was not seen on the MRI beforehand. If this tear is large enough, then the rotator cuff is repaired. This lengthens the recovery time and changes the rehabilitation protocol after surgery.
Although most patients have significant relief after shoulder surgery, it is not uncommon to have occasional stiffness or soreness in the shoulder after the operation. The risks associated with shoulder surgery are generally low, but there are some specific complications that can occur:
- Continued pain or stiffness due to scarring in the shoulder
- Progression of rotator cuff tearing
- Non-healing of the rotator cuff (if a repair was attempted)
- Development of acromio-clavicular (AC joint) arthritis
A more general complication of surgery can also occur. These include:
- Deep venous thrombosis (aka “blood clot” or DVT)
- Infection (all patients receive antibiotics at the time of surgery to decrease this risk)
- Nerve injury (associated with numbness, weakness, or paralysis)
- Vascular injury or compartment syndrome
- Complications associated with the anesthesia