Arthroscopic Subacromial Decompression

Arthroscopy is a minimally invasive surgical technique used in the treatment of sports medicine injuries. It involves the use of a fiber-optic camera, which we place into a joint through a small incision in order to visualize ligaments, cartilage, and soft tissue. Through another small incision, we can then use small instruments to remove or repair broken or damaged tissue.

Shoulder arthroscopy with a subacromial decompression is surgery performed on patients with impingement syndrome of the shoulder. The acromium is a bone that rests on top of the rotator cuff, which can develop spurs that can irritate and abrade against the rotator cuff. This anatomy can narrow the subacromial space and cause pain and damage to the rotator cuff. Due to this narrowing, the rotator cuff is pinched against the undersurface of the AC joint and can cause tendonitis. This is a significant source of pain. Over time, chronic shoulder impingement can lead to degenerative rotator cuff tears.

 Shoulder arthroscopy with a subacromial decompression involves first, cleaning out the shoulder of any debris or inflamed tissue. Then, by using a small shaver device, the undersurface layer of the acromion is removed. The space below the acromium where the rotator cuff passes is thus made wider. By doing this, the rotator cuff can freely pass without rubbing on bone and becoming inflamed or impinged.

Post Operative Instructions:

SLING/MOVEMENT

  • You may wear the sling as tolerated for comfort. Commonly, patients remove the sling within 3 days.
  • You may move your shoulder in any direction that is comfortable. Do not force the motion though because this will likely cause pain.

ICE

  • An ice machine will be provided to you prior to your surgery. This will help decrease swelling and pain after your surgery. Use the ice machine as much as possible when you get home at intervals of 30 minutes on and off. You should keep the ice machine for approximately two weeks. Do not use the ice machine while you are sleeping.

MEDICATIONS

  • An injection of local anesthesia was injected into your shoulder after the completion of the operation. This medication will wear off in 5 to 6 hours. Therefore, begin taking the pain medication (e.g. Vicodin, Percocet, etc) immediately when you get home. This will prevent you from having severe pain. Take the pain medication every 4 hours until you go to bed.
  • The day after surgery you can take 600 mg of Ibuprofen (Advil/Motrin) every 6 hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking the Ibuprofen, continue taking the pain medication every 4-6 hours as needed.
  • A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.

DRESSING/BANDAGES

  • Your shoulder dressing is waterproof. You may shower the next day after surgery. Two days after surgery you may remove the entire dressing. Gently wash the wounds with soap and warm water and towel dry. You may then cover the incisions with band-aids until your post op visit.
  • Do not take a bath or submerge your shoulder in water until your incisions are checked at your first post-op visit.

APPOINTMENT

  • Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.

If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.

Download the postoperative instructions for your procedure (PDF) 

Recovery Timeline:

Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one hour, and recovery time is one hour. For immediate post-op instructions, download the instruction sheet.

One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Stitches will be taken out, and you’ll get to see your pictures from the surgery. Continue icing two to three times a day (or more if needed). Discontinue sling at this time. Physical therapy will be prescribed. Start physical therapy immediately to work on range of motion.

Four weeks post-op: Second follow-up visit. Range of motion and strength test. Physical therapy will continue to improve rotator cuff strength. Stiffness and mild discomfort at night and with certain motions is common at this stage of the rehab process.

Eight weeks post-op: Third follow-up visit. Range of motion and strength testing. If additional range of motion or strength training needed, continue physical therapy to work on rotator cuff strengthening. Pain should be mostly resolved at this point.

Twelve weeks post-op: Fourth follow-up visit. Range of motion should be full/normal. You should feel stronger and have very little pain, if any. Near to full recovery expected at this time. Some patients will require additional four weeks of physical therapy to continue with rotator cuff strengthening exercises.

 





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