What is a Shoulder Arthroscopic
Decompression?
Shoulder Arthroscopic Decompression is to take pressure off the
inflamed shoulder tendons and to provide a pain free mobile and
strong shoulder. The operation is suitable for people whose
symptoms have not responded to non-operative methods such as
injections or physiotherapy. They have usually undergone assessment
of the tendons in the form of an ultrasound scan or MRI scan
Overall, this sort of surgery should have a success rate of
eight and a half to nine out of ten with substantial reduction in
pain and a return to normal activity.
What does this involve?
Shoulder Arthroscopic Decompression is performed under general
anaesthetic and takes around one hour. Local anaesthetic is
also used as part of the pain relieving technique either by direct
injection into the site of the surgery or by numbing the nerves to
the whole arm using a technique called a regional block. This is
similar to the idea of an epidural anaesthetic frequently used in
childbirth and can have benefits in not only providing excellent
postoperative pain relief but also in reducing postoperative
sickness and nausea.
The surgery is carried out through small incisions around your
shoulder using telescopic instruments. The aim of the operation is
to remove bone at the front of your shoulder (the acromion) which
is pressing on the inflamed and damaged tendons. The first step is
to use the telescope to carefully assess the whole of the inside of
your shoulder joint and tendons. This allows the identification of
other problems that might be important, such as arthritis and also
allows other minor problems to be dealt with. The main part of the
operation involves removing the inflamed soft tissues (bursa and
ligaments) and the bone (anterior acromion) pressing on the top of
the shoulder tendons actually outside the main shoulder joint.
Sometimes the joint between the collarbone and the acromion (the
acromio-clavicular joint) also needs to be removed as part of the
procedure.
Once the operation is complete, the small incisions are closed
with single stitches that are removed after a week and covered with
waterproof dressings.
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When will I recover?
The operation generally requires a one night stay in hospital
and your arm is placed into a special shoulder sling which is
primarily for comfort and support. Exercises and physiotherapy
start on the day of surgery and patients are your physiotherapist
will teach you all you need to know for the first couple of weeks
after discharge from hospital.
As a general guideline the sling is rarely necessary for a
period of more than two weeks. During this time, you are encouraged
to start using your hand but it is unlikely that you will be able
to do much actively with the arm when the shoulder is moved away
from the body. Most people can start driving a car between two and
three weeks and have regained good ordinary use of the shoulder by
six weeks. Inflammation and discomfort generally settle over a
period of two to three months and physiotherapy and exercises
continue for this period of time. Activities such as running and
swimming start to be resumed at around four weeks but activities
that are more demanding on the shoulder such as racquet sports,
golf and gardening are resumed at two to three months.
In addition to regular treatment with the physiotherapist,
follow up should be carried out by your surgeon. This is to monitor
and guide progress and look out for complications, which are
fortunately rare.
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What risks should I know about?
Shoulder Arthroscopic Decompression is a very
successful operation but there are some potential complications you
should be aware of even though they are uncommon.
- Infection can occur although it is rare and infection rates are
less than 1%.
- Shoulder stiffness can occasionally be triggered off by the
operation and can be treated by injection.
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Circle care
Shoulder surgery is carried out in our specialist area at
CircleBath where our specialist shoulder surgeons are available and
have the expertise to get the best possible results. You can
be sure of state of the art facilities and the best possible care
to get you back to normal as soon as possible.
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