FAQs on Shoulder Arthroscopic Decompression
Shoulder arthroscopic decompression is an option when non-surgical treatments fail to relieve subacromial impingement. The procedure is found to be reliable in alleviating pain and improving functional ability of 85% to 90% patients with shoulder impingement.
What is shoulder arthroscopic decompression?
Shoulder arthroscopic decompression is a surgical technique performed to relieve shoulder impingement caused by narrowing down of the subacromial space. Impingement is a common cause of shoulder pain when patients raise their hands, as the pressure from the acromion (bony top) under-surface cause trapping and pinching of rotator cuff and forces bones and tendons in shoulder to rub against each other.
Shoulder arthroscopic decompression takes of pressure by removing “removing the inflamed bursa, any fraying of cartilage or bone spurs on the under-surface of the acromion.”
What is shoulder subacromial impingement?
Shoulder subacromial Impingement occurs as the bursa between the acromion and rotator cuff gets scarred and inflamed. As a result, the space narrows down and rotator cuff tendon is trapped and impinged. It may also be caused by tendonitis, bone spurs, or rotator cuff tear and leads to pain and restricted shoulder motion.
How does shoulder arthroscopic decompression provide relief?
Shoulder arthroscopic decompression increases the subacromial space and reduces pressure responsible for impingement. It removes the ligament or acromion bone spurs to alleviate pinching and trapping of the rotator cuff and tendons. If necessary, the acromion is resurfaced or reshaped to prevent any impingement.
Who is a candidate for shoulder arthroscopic decompression?
Shoulder arthroscopic decompression is suggested for those with shoulder impingement. However, the surgical procedure is the last option and is recommended only after all non-surgical treatment options are exhausted. Patient may be prescribed the option directly, if a doctor considers that their conditions are only amenable to decompression surgery following diagnostic tests and preliminary anti-inflammatory medication.
How is shoulder arthroscopic decompression performed?
- Initial Incision and Fluid Pumped
The patient is administered general anesthesia is applied and create a small incision is made on the shoulder. A tiny tube is used to pump fluid into the joint. This enlarges the joint and allows surgeons to have a clear view.
- Arthroscope Inserted
An arthroscope, a tube-like fiberoptic camera is inserted into the joint after another small incision is made on the skin above it. This used to get live images and guide the surgical process without the need for open incision. Once the arthroscopic images confirm the exact cause of impingement, specialized instruments are inserted through a few small incisions.
- The Surgery
- If the bursa is inflamed, it is removed to increase the space underneath the acromion.
- If the reason is coracoacromial ligament, it is removed to relieve pressure on the rotator cuff.
- If bone spurs are on the under-surface of the acromion, these are shaved away.
- Surgeon may remove the edges of the acromion and clavicle to enhance the subacromial space and ensure smooth movement of rotator cuff tendons.
Incisions are closed and the area is bandaged once the surgery is over.
How long does shoulder arthroscopic decompression surgery take?
The procedure takes 30 to 45 minutes and is done in an outpatient setting.
Do I need to stay at the hospital after shoulder arthroscopic decompression?
Patients are discharged same day after a few hours of observation for possible complications.
Do I need rest after shoulder arthroscopic decompression?
Patients need complete rest for 2 days and have self-care to avoid complications. You can return to sedentary work or desk jobs after 2 weeks. But return to job requiring high-impact activities or sustaine arm movement must wait until 6 weeks.
What are the restrictions following shoulder arthroscopic decompression?
- Keep incisions clean and dry for 3 to 5 days
- No shower for 72 hours
- Avoid extreme arm positions for 1 week
- No lifting for 3 weeks
- Use a sling for 3 weeks
- No driving for 4 weeks
- No lifting or rotating of the arm for 1 week
- Activity level subject to comfort and level of tolerance
- No sports activities for three months
What kind of rehabilitation is needed following shoulder arthroscopic decompression?
The rehabilitation aims at preventing stiffness in the shoulder and helping it gain structural and functional strength. This may include the following.
- Day 1-14: Non-painful range of motions, assisted active range of motions, non-forceful flexion and abduction, pendulums, self streches. No upper extremity elevation.
- Week 2 to 6: Activities to regain muscular strength, neuromuscular control, and arthrokinematics, such as isotonic and isotonic workouts, shoulder musculature exercises, upper extremity endurance workouts, cryotherapy, etc. No heavy lifting or overhead workout.
- Week 6 to 12: Strength, power, and endurance workouts, progressive throwing activities, increasing speed, high energy strengthening workouts, dumbbell strengthening, theraband exercises, isokinectics, eccentric exercises, etc.
How long is the recovery period following shoulder arthroscopic decompression?
By six weeks, most patients have good ordinary shoulder movements. It takes about 2 to 3 months to completely recover and patients can do all activities except high-impact ones. Shoulder regains most of its original strength in six months.
What are the potential complications of shoulder arthroscopic decompression?
Like other surgical procedures, patients undergoing shoulder arthroscopic decompression may suffer from temporary stiffness, bleeding, pain, infection, and nerve injury. However, infections and nerve injury can be avoided by following the right surgical protocol. Stiffness, bleeding, and pain subside within a few days.
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