Subacromial decompression (acromioplasty) is an operation used to treat subacromial impingement. Subacromial Impingement is a condition where the rotator cuff tendon is pinched between the humeral head and the undersurface of the acromion.
Subacromial decompression consists of removal of a small portion of the bone (acromion) that overlies the rotator cuff, aiming to relieve pressure on the rotator cuff in certain conditions and promote healing and recovery. Although subacromial decompression may be beneficial in the management of partial and full-thickness tear repair, this procedure does not physically repair the tear and arthroscopic decompression has more recently been combined with “mini-open” repair of the rotator cuff, allowing for the repair of the cuff without disruption of the deltoid origin. Decompression alone tends to degrade with time, but the combination of repair and decompression appears to produce better results.
During a subacromial decompression, the inflamed portion of the bursa is removed and the bony prominence on the undersurface of the acromion is shaved down to open up the space between the rotator cuff and the acromion. This allows the rotator cuff to glide more smoothly between the head of the humerus and the acromion; therefore, causing less pain or damage to the rotator cuff and less inflammation of the bursa.
The procedure is done arthroscopically, which means that a video camera and small specialized tools are inserted through a series of small incisions to complete the bursa removal and shaving of the acromion bone. The benefit of performing the procedure in this minimally-invasive way is that the patient can expect a much more rapid recovery with less overall surgical pain. The surgery is followed by a course of formal physical therapy that is tailored to each patient’s specific needs. Typically, the procedure is done on an outpatient basis and patients are able to return to work and regular daily activities within a few weeks.