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Surgery may be used to treat a rotator cuff disorder if the injury is very bad or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently. Subacromial smoothing involves shaving bone or removing growths on the upper point of the shoulder blade (acromion). It removes damaged tendon and bursa from the joint. The surgeon may also remove small amounts of bone from the underside of the acromion and the acromioclavicular joint (acromioplasty). The goal is to take away roughness while keeping as much of the normal supporting structures as possible. This surgery creates more room in the subacromial space. With more space, the rotator cuff tendon is not pinched or irritated and can glide smoothly beneath the acromion.
Subacromial smoothing, acromioplasty, and rotator cuff repair may be done using arthroscopic surgery or open surgery.
You may have general anesthesia during arthroscopy, or you may have a regional nerve block.
You may go home a few hours after waking up from anesthesia. A family member or friend should drive you home. In some cases, the doctor may suggest that you stay overnight for help with pain and for observation. You will probably need help from friends or family for the first 2 weeks after surgery.
Discomfort after surgery may be relieved by:
With a doctor's approval, you may be able to return to light work within a few days after surgery even if you are using a sling.
after surgery is crucial for a successful recovery. A typical rehabilitation schedule includes the following:
When normal shoulder strength and range of motion return, usually after about 6 to 8 weeks, you can gradually increase your activity level.
Smoothing may be done for people who:
Also, if you have a rotator cuff tear, you may have arthroscopic smoothing before open surgery.
Surgery to smooth the bones and create more space for the rotator cuff may lead to less pain with shoulder movement.footnote 1
In addition to the general risks of surgery, such as blood loss or problems related to anesthesia, complications of subacromial smoothing surgery for rotator cuff disorders may include:
Subacromial smoothing using arthroscopic surgery can usually improve shoulder function as well as open surgery can but without some of the drawbacks of open surgery. The benefits of arthroscopic surgery for subacromial smoothing include:
Beasley Vidal LS, et al. (2007). Shoulder injuries. In PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, pp. 118-145. New York: McGraw-Hill.
Other Works Consulted
Lin KC, et al. (2010). Rotator cuff: 1. Impingement lesions in adult and adolescent athletes. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine, Principles and Practice, 3rd ed., vol. 1, pp. 986-1015. Philadelphia: Saunders Elsevier.
ByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency MedicineAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineKenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
Current as ofNovember 29, 2017
Current as of:
November 29, 2017
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
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