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What kind of shoulder surgery is done for impingement syndrome?

The primary aim of the surgical treatment of shoulder impingement is to make more space available for the tendons of the rotator cuff. Enlarging, or "decompressing" the space between the acromion and the head of the humerus can relieve the symptoms of impingement. Removing a part of the acromion can stop the tendons of the rotator cuff from rubbing on the bone. This type of surgery is called an acromioplasty. Because inflammation in the subacromial bursa contributes to the pain of impingement syndrome, this lubricating sack is often removed. This part of the procedure is called a bursectomy or a debridement. These two procedures together are called a sub-acromial decompression.

Acromioplasty surgery can be performed with an arthroscope or with an open technique and a larger incision. The primary advantage of arthroscopic subacromial decompression is a shorter recovery time. This is the case because the incisions that are required in order to be able to see the subacromial space are smaller when an arthroscope is used. However, there are some instances in which the anatomy of the patient's shoulder makes it difficult to see well enough to perform safely an adequate sub-acromial decompression. In these instances, a larger incision has to be made.

In general, the recovery from this surgery is usually quite quick. Motion is started very soon after surgery in order to speed up the rehabilitation process.

Many patients who have shoulder impingement syndrome also have a painful acromio-clavicular joint that can be a partial cause of their shoulder pain. A/C joint arthritis and shoulder impingement syndrome often occur together, in the same shoulder. When the patient has shoulder pain that seems to be related to the A/C joint, a distal clavicle resection is often performed at the same time as a subacromial decompression. This procedure removes that last four or five millimeters of the clavicle and increases the amount of space in the acromio-clavicular joint. It has very few disadvantages and can be very effective in treating painful arthritis of the shoulder joint.

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