Acromioplasty is a surgical procedure that treats shoulder impingement and rotator cuff disease. It involves removing a small piece of bone and soft tissue from the acromion.

In this article, we look at why people might need acromioplasty and what it involves, as well as the recovery, benefits, and complications.

What is acromioplasty?

Acromioplasty

Acromioplasty is a surgical procedure that involves shaving away part of the shoulder bone called the acromion.Surgeons carry out the procedure to relieve the impingement of the rotator cuff tendon that supports and strengthens the shoulder joint.

Acromioplasty is also known as a subacromial decompression.

Why undergo acromioplasty?

A doctor might suggest acromioplasty as a treatment option for people who are experiencing shoulder pain, particularly with overhead activity, and reduced strength in the shoulder or arm. Some of these individuals may also have difficulty reaching the arm behind the body, for example, to do up a zipper.

These symptoms may occur due to the following conditions:

Shoulder impingement

The four muscles of the rotator cuff surround and support a person’s shoulder.

One of the tendons that connect these muscles to the top of the arm bone can become pinched between the two bones, resulting in shoulder impingement. A person will feel pain in this area, especially when they lift their arm to the side and above shoulder height.

There are several possible causes of impingement, including the following:

  • doing a job or sports activity that requires lifting the arm in overhead positions
  • as a person ages, the underside of the acromion may develop bone spurs that narrow the space between the bones of the shoulder
  • overuse of the tendons from sports may cause them to become swollen or torn

Rotator cuff tears

The tendons in the rotator cuff can become torn because of injury, or this damage can develop over time.

Both surgical and nonsurgical treatments are available for the treatment of rotator cuff tears. According to an article in the World Journal of Orthopedicsthe preferred surgical procedure varies from surgeon to surgeon.

2018 review suggested that using acromioplasty alongside rotator cuff repair did not lead to clinically significant improvements in shoulder function and pain.

What is the procedure?

An orthopedic surgeon performs the procedure under general anesthetic.

The surgeon aims to make more space under the acromion by removing some of the bone, usually from its underside.

They will typically perform keyhole surgery (arthroscopy), which involves inserting a small, tube-like camera called an arthroscope through a small cut in the skin.

The surgeon uses the arthroscope to look inside the shoulder and then carries out the procedure with special surgical instruments.

The surgeon will look at the rotator cuff tendons. If these have torn, the surgeon will repair them so that the person does not need to undergo a second surgery.

To do this, the surgeon may sometimes need to make a larger incision. However, the entire operation most often takes place arthroscopically through the small keyhole incisions.

Recovery process

After the surgery, the person will usually wear a sling to support the arm. The length of time for which people need to use the sling varies hugely, so a person should ask the surgeon for their recommendation.

People can also take anti-inflammatory medication, such as ibuprofen, or use an ice pack after the surgery to relieve pain.

After surgery, many people take part in a rehabilitation program, which may include support from a physiotherapist. This specialist can tell the person what exercises they can do at home to regain their strength and mobility.

It can take 2–4 months to achieve complete relief of pain after acromioplasty. When a person also undergoes a rotator cuff repair, it can take 6–9 months to make a full recovery.

A medical professional can offer advice on when it is safe to return to work.

Risks and complications

Infection may be a risk after surgery.

Signs of infection include:

  • the wound being hot, red, or swollen
  • bleeding or drainage from the incisions
  • worsening pain
  • a high temperature

Anyone who is considering having acromioplasty should discuss the potential risks and complications with their surgeon or doctor.

Some of the possible complications include:

  • nerve damage
  • damage to blood vessels
  • infection
  • stiffness or “frozen shoulder”
  • anesthesia complications

Summary

Acromioplasty may be a suitable procedure for someone who has shoulder impingement. Surgeons often carry out this procedure when they are performing surgery for a rotator cuff tear.

A person should ask a doctor about the treatment options for their condition. The doctor may also discuss other factors, such as risks, complications, and how the condition is affecting a person’s life.

Other aspects to consider include the recovery time, any help the person might need during their recovery, and what rehabilitation might involve.

A person will need to weigh these up against their current quality of life to help them decide whether surgical or nonsurgical treatments are likely to be best for them.

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