Acromioplasty & Subacromial Decompression
Acromioplasty, also called subacromial decompression, is a surgical procedure performed to relieve shoulder pain caused by shoulder impingement syndrome. By reshaping the acromion (the top part of the shoulder blade) and removing inflamed tissue, the surgery creates more space for the rotator cuff tendons, reducing friction and pain.
What Is Acromioplasty?
The acromion is a bony projection of the shoulder blade that forms the top of the shoulder. In some people, this bone is curved or develops spurs that rub against the rotator cuff tendons when lifting the arm. Acromioplasty involves trimming or smoothing part of the acromion to create space and prevent this pinching.
What Is Subacromial Decompression?
The subacromial space is the narrow gap between the acromion and the rotator cuff tendons. When inflamed or narrowed by spurs, it can cause painful impingement. Subacromial decompression removes inflamed tissue (bursa) and bony prominences, relieving pressure on the rotator cuff tendons.
When Is Surgery Needed?
Most people with impingement improve with physiotherapy, rest, and injections. Surgery is usually considered if:
- Pain persists for more than 6–12 months despite non-surgical care
- You have difficulty lifting the arm overhead
- You experience night pain that disturbs sleep
- X-rays or MRI show bone spurs or narrowing of the subacromial space
How Is the Procedure Performed?
Acromioplasty and decompression are usually done arthroscopically (keyhole surgery):
- Small incisions are made around the shoulder
- An arthroscope (camera) is inserted to view the subacromial space
- Inflamed bursa tissue is removed
- The acromion is reshaped and bone spurs are trimmed away
- Incisions are closed with sutures or dressings
The surgery typically takes 30–60 minutes and may be combined with rotator cuff repair if a tear is present.
Recovery After Acromioplasty
- Sling use: Usually 1–2 days for comfort
- Physiotherapy: Starts within the first week to restore movement
- Desk work: Return in 1 week
- Manual work: 4–6 weeks, depending on pain and strength
- Sport and gym: Gradual return after 6–8 weeks
Recovery is usually quicker than rotator cuff repair, as tendons are not stitched back to bone.
Benefits of Surgery
- Relief from shoulder impingement pain
- Improved range of motion
- Better sleep and comfort lying on the shoulder
- Faster return to daily activities
Risks and Complications
Acromioplasty and decompression are safe, but risks include:
- Infection
- Bleeding
- Shoulder stiffness
- Incomplete pain relief (especially if other shoulder problems are present)
- Nerve or vessel injury (rare)
When to See a Specialist
If you have ongoing shoulder pain from impingement that does not improve with physiotherapy and injections, a consultation with a shoulder surgeon can help determine if acromioplasty or decompression is right for you.