If pain and disability of the shoulder continue, despite nonoperative treatments, surgery may be considered. Surgery for bursitis or impingement surgery is called a ‘subacromial decompression’ and involves the removal of the inflamed bursal tissue over the rotator cuff, as well as the shaving of the acromion bone which can narrow the space above the rotator cuff. A partial rotator cuff tear may only require a trimming or smoothing procedure called a ‘debridement.’ But, if the tendon is completely torn away from its insertion on the humerus bone, it can be repaired directly to the bone.
Most surgical procedures can be performed on an outpatient basis. The surgical procedure in the majority of cases involves minimally invasive shoulder arthroscopy. By use of a tiny fiber optic scope and other small instruments inserted through small incisions, the bone shaving and tendon “debridement” can be carried through under video control. This allows for a smaller, less invasive incision.