Procedure
The operation is done by key hole surgery; usually through two or three 5mm puncture wounds. It involves removing the calcium and shaving away part of the acromion bone (subacromial decompression). The calcium deposit is located and scraped out.This increases the space of the subacromial area and reduces the pressure on the muscle and bursa allowing them to heal.
Pain may arise as well from the small joint between the shoulder blade and the collar bone (Acromio-clavicular joint (AC joint)) due to a cartilage tear or arthritis with wear & tear. In these cases resection arthroplasty of the AC joint with removal of few milimeters of bone from each side of this joint is performed.
Your shoulder will be examined under anaesthetic (EUA), if it will be found stiff with restricted movement – manipulation under anaesthetic (MUA) for release of the contracture may be needed.
If a rotator cuff tear is detected during arthroscopy, the surgeon may need to repair this torn tendon.
A repair involves stitching the torn tendon back onto its attachment to the arm bone (Humerus). This is done using tiny anchors with sutures attached to them to reattach the torn tendons back to the bone. The repair should be protected until healing takes place (for initial healing – 6 weeks).
This will involve a different post operative regime to ASD/ Excision of calcific deposit – you will NOT BE ALLOWED to use your arm or drive for 6-8 weeks. If you wish that the torn tendon will NOT be repaired – please let the surgeon know before surgery!
Complications
As with all surgery there is a risk of some complications. These are rare, but you should be aware of them before your operation.
They include:
- Complications relating to the anaesthetic.
- Infection.
- Failure to achieve successful result.
- A need to redo the surgery.
- Injury to the nerves or blood vessels around the shoulder.
- fracture
- Prolonged stiffness and or pain.
If you require further information please discuss with the doctors either in clinic or on admission.
General Advice
You will usually be in hospital either for a day or overnight. A doctor/physiotherapist will see you prior to discharge and you will be taught exercises to do and given further advice to guide you through your recovery. You will be given a sling. This is provided purely to keep your arm comfortable. It may be taken off as much as you wish and discarded as soon as possible. You will be encouraged to use your arm. You should be back at work between one and four weeks depending on your job. Your symptoms should be approximately 80% better after three months but may take a year to totally settle.