Arthroscopic subacromial decompression

This information will help you to gain the maximum benefit from your procedure. It is not a substitute for professional medical care and should be used in conjunction with your medical treatment. 

About your shoulder

A shoulder is a ball and socket joint. The joint is surrounded by a deep layer of tendons called the rotator cuff. When the arm is lifted up to the side or in front of the body, these rotator cuff tendons pass underneath a bony and ligamentous arch called the coracoacromial arch. These tendons, most commonly the supraspinatous tendon, can rub on the bone and the ligament of the arch, resulting in pain over the side of the upper arm called rotator cuff impingement syndrome. The tendon can become inflamed, thickened, painful and worn, and may even tear. This rubbing of the tendon can settle with time, rest, physiotherapy and Cortisone injections. However, if symptoms are persistent, surgery called arthroscopic subacromial decompression may be necessary.

About the subacromial decompression

This is an arthroscopic (keyhole) procedure designed to release the tight ligament of the coracoacromial arch and to shave away some of the under surface of the acromion. This raises the roof of the shoulder, allowing more room for the rotator cuff tendons to move underneath. The tendon is then able to move more freely, breaking the cycle of rubbing and swelling of the tendon.

This operation is generally performed as a day case procedure with an interscaline nerve block and general anaesthetic.  However, surgery is more frequently being performed under interscaline block and light sedation.

Success rate

The success rate for this procedure is around 80% but it may take a number of months, even up to a year, to see the full benefit. 

Risks and complications

There are risks and complications with the procedure and although they do not occur frequently, it is important to know what they are. 

Anaesthetic risks

There are very small risks with anaesthesia and the anaesthetist will discuss these with you on the day.

Surgical risks

There is a small risk of infection, probably less than 1%.

There is a small risk of worse pain and stiffness around the shoulder in the form of a frozen shoulder, which can occasionally occur after shoulder surgery in about 1% of cases. There are very small risks of damage to the nerves and blood vessels around the shoulder, less than 1%. 

There is the occasional need to re-do the surgery, but this is rare, less than 5%.