Arthroscopic Subacromial Decompression
What is it?
Following a routine shoulder arthroscopy, a shaver is introduced into the sub acromial space and the bursa, and the underside of the acromion is removed with a burr. This removes the painful, inflamed tissue and creates more space for the tendon in the shoulder joint.
The surgery is done with an anaesthetic block to numb the arm. You can be awake during the operation or have some sedation to make you sleepy. As the operation uses water to see inside the joint, the wounds will leak some fluid which will be absorbed by cotton wool dressings. These dressings are removed a few hours after surgery.
What should I expect during recovery?
Once the anaesthetic has worn off after approximately 4-8 hours, the shoulder can feel painful so you will need to take regular pain relief. Even though you may be pain free at rest, you should take regular pain relief for when you move the shoulder as part of your rehabilitation program. A combination of paracetamol or codeine should be taken with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, unless contraindicated. If the pain relief is not sufficient please contact your consultant’s secretary or your GP.
The ward nurses will change your dressings and should provide some waterproof dressings to take home with you, so that you can bath or shower keeping the wounds dry. You will also be given a sling which will protect your shoulder and help with pain relief. You will be shown how to use this before you leave the hospital. Following this you can go home the same day.
You will need a dedicated physiotherapy program after your surgery. If you have been seeing a physiotherapist prior to your surgery, you should arrange to see them afterwards so you can start your rehabilitation straight away. If you do not have a physiotherapist we can arrange a referral for you.
Once the sling is removed, exercises to rehabilitate the ligaments will be started. These will improve the range of motion in your shoulder and prevent scarring as the ligaments heal. Exercises to strengthen your shoulder will gradually be added to your rehabilitation plan. Be sure to follow the treatment plan. Although it is a slow process, your commitment to physiotherapy is the most important factor in returning to all the activities you enjoy.
When can I return to driving?
If you are comfortable and feel able you can return to driving after 1 week.
When can I return to work?
You can return to a sedentary job such as office work as soon as you feel able. Most patients return to light manual work at 3 weeks and heavy labour at 6 weeks. Shoulder movement is beneficial to the recovery process so early movement will not cause any harm.
When can I return to exercise?
As a guide, you can return to swimming and golf after 3 weeks and contact sports after 6 weeks.
The One Team Specialists
Anthony Hearnden
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist
