Arthroscopic acromioplasty for Impingement Syndrome

April 25th, 2007

“Impingement” of the rotator cuff is one of the most common causes of pain in the adult shoulder. It results from pressure on the rotator cuff from the acromium as the arm is lifted overhead. The acromium may have a curved shape—which causes bony impingment. The acromion is the front edge of the shoulder blade. It sits over and in front of the humeral head. As the arm is lifted, the acromion rubs on the rotator cuff, and eventually results in either partial or full thickness tears of the supraspinatus or infraspinatus tendons.

Physical therapy and a subacromial cortisone shot are successful in up to 85% of patients. If, however, pain and limited use continue beyond 3 months, arthroscopic "acromioplasty" and bursectomy is an option. This outpatient procedure takes 30 minutes and can be performed under a regional anesthesia.

A sling is worn for 5-7 days. PT is helpful for the first 4-6 weeks, and usually recovery is near complete by 2 months. Although this intervention is more agressive than "conservative" treatment, it restores normal function in the vast majority when shoulder pain fails to improve with therapy.

Related Photos:

Type 3 acromial spur will be shaved away--creating a flat acromial surface

Beach chair position during shoulder arthroscopy

Related Videos:

1.CA (coracoacromial) ligament identified

2. CA ligament released with the radiofrequency probe

3. Bursectomy is performed with a shaver

4. Residual CA ligament is smoothed

5. Acromioplasty (subacromial decompression) is performed

6. The acromial undersurface is now smooth

7. The rotator cuff in in tact, but an "impingement lesion" is noted