What is Acromioplasy and when it is necessary ?

An acromioplasty, also called subacromial decompression, is a keyhole surgery that involves shaving away the undersurface of the acromion. The acromion is a triangular-shaped bone located in the shoulder which extends out from the shoulder blade to the top of your shoulder joint. It provides attachment to the trapezius and deltoid muscles around the shoulder. 

The acromion forms the acromioclavicular joint along with the collarbone, and it is also attached to the scapular spine. Repeated shoulder movements cause the acromion to rub against the muscles (tendons) in the shoulder, possibly damaging it. 

This acromioplasty tends to create room for the rotator cuff tendons to move freely so that it may not put pressure on the undersurface of the acromion. Thus it minimizes or prevents the friction that develops between the acromion and tendon and also relieves the pain completely caused by it.

Who can undergo acromioplasty?

For patients who have suffered from acromioclavicular joint injuries, primarily men over 35, an acromioplasty or subacromial decompression would be beneficial.

Usually, this procedure is used to treat AC joint injuries caused by overuse. As repetitive pressure on the acromion bone causes the cartilage to wear down. In such cases, the bones come in contact directly with the tendons, which increases the likelihood of severe tendon injury and can result in symptoms, like:

  • Shoulder pain
  • Swelling and tingling sensation
  • Loss of shoulder strength
  • Bump on top of the shoulder
  • Reduced range of motion in the shoulders
  • When you move your shoulder, a catching sound may occur

Recovery from an acromioplasty is fairly quick, so that the long term use of slings is rarely necessary. Usually, recovery from the procedure is approximately six weeks if the surgery is performed in a minimally invasive way. But in the case of open surgery, the recovery process can last for six to twelve months.

For the first few days following surgery, patients should rest their shoulders completely. However, in order to maximize shoulder strength, boost the recovery process, and reduce complications, it is strongly recommended that patients begin physiotherapy immediately after surgery.

Decompression surgery (acromioplasty) is very effective in treating shoulder impingement syndrome. Some other conditions that doctors can treat with this procedure include:

  • Shoulder arthritis
  • Bone spurs
  • Bursitis
  • Rotator cuff tears

How does acromioplasty work?

Most often, this surgery is performed through keyhole surgery or arthroscopic surgery. It is minimally invasive surgery in which the surgeon uses a camera-head device called an arthroscope to look at the interior parts of your shoulder. It also guides the surgeon to reach the damaged area.

During the surgery, the patient is positioned in a supine posture with the affected shoulder elevated. The surgeon makes an incision along the anterior tip of the acromion. After making an incision, the surgeon will send the arthroscope to view inside and some surgical instruments to repair the damage. Once he reaches the position, he will detach some fibres to gain access to the damaged area and then proceed to perform the necessary procedure to reduce the size of the acromion.

In addition, the surgeon will evaluate the condition of the rotator cuff tendons to ensure they are damage free. If there is any damage, he will fix them during the same procedure. After the procedure is completed, the surgical site is dressed.

Recovery from surgery 

Following the surgical procedure, probably you may need to wear a sling that supports your arm. It varies greatly for each person how long they need to wear a sling, which is why you should follow the instructions of the surgeon.

To get relief from pain after the surgery, patients can use ice packs or take anti-inflammatory medicine like ibuprofen.

Rehabilitation program following surgery helps many people to recover safely and quickly, where you will be supported by a physiotherapist for physical therapy. This specialist instructs you on the type of exercises you have to do at home to restore your strength and mobility.

However, the recovery is based on several factors. Some people recover quickly within two months, whereas others might take 2–4 months to recover completely after acromioplasty. When a rotator cuff is also repaired during acromioplasty, it may take around 6 months – 9 months for a full recovery.

If you’re not sure when it’s safe to go back to your work, speak to a medical professional. If you are experiencing any shoulder pain or any other joint pain, consult Dr. Ajay Tiwari, the best orthopaedic joint surgeon in Hyderabad. He has more than 15+ years of experience as an orthopaedic doctor & unparalleled expertise in treating joint problems. Call +91 98499 82203 to schedule an appointment.

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