Advice on Subacromial
Decompression
Before embarking on subacromial decompression you should
be aware of the following facts. If you have any other questions you should ask your surgeon for further information.
Benefits
- Relief of pain: Approximately 85% of
patients can expect to lose all, or virtually all, of their
shoulder pain.
- Range of movement: The range of shoulder
movement will normally return to normal provided your rotator
cuff is intact. If the decompression is being done to treat a
cuff tear you may always have some limitation in your ability to
elevate your arm.
Risks
General risks
associated with any surgery
-
Cardiovascular problems: Heart attack and
stroke can occasionally be caused by anaesthesia and surgery.
The risks of this complication are normally exceedingly small in
healthy individuals. The risk may be greater if you have
pre-existing disease, in which case your anaesthetist / surgeon
will discuss this with you.
-
Thromboembolism: Blood clots may
sometimes form in the veins of your legs, a condition known as
'deep vein thrombosis.' This may cause excessive swelling of
your legs and may require treatment with blood thinning drugs.
Extremely rarely the clot may become detached and travel to the
lungs; this is a potentially fatal complication known as a
'pulmonary embolus.' There are some conditions in which the risk
of thromboembolism is increased (e.g. patients on the
contraceptive pill or HRT), in which case you may be given
medication to reduce the risk.
-
Infection: Infection can complicate any
surgery, but is rare following arthroscopy (risk much less than
1%). It may be possible to treat this with antibiotics alone,
although further surgery to drain the infection may be
necessary.
Specific risks of
subacromial decompression
-
Failure to relieve symptoms: Up to 15% of
patients do not respond to surgery. The majority of these
patients find their symptoms similar to those prior to surgery.
-
Progression of pathology: Subacromial
decompression will not necessarily prevent progression of
rotator cuff disease. Deterioration in symptoms may therefore
occur at a later date.
Surgery details
-
Surgery will be done under general anaesthesia.
Your anaesthetist will discuss this with you. You may also have
a local anaesthetic injection to control post-operative pain;
again this will be discussed prior to surgery
-
The operation will take about 1
hour
-
You will normally have 2 and sometimes 3 small
incisions over the shoulder. These will either be closed with a
suture or a skin tape
-
You will normally return home within 12 hours of
surgery; this may mean an overnight stay if your surgery is done
in the afternoon
Recovery
-
You will be encouraged to move your shoulder as
much as possible after surgery. You may be given a sling for
comfort, but unless advised to the contrary you should try to
remove this as soon as possible
-
To help shoulder movement a course of
physiotherapy will normally be advised
-
You can expect increased pain from your shoulder
for about 2 to 6 weeks
-
Most people are able to drive within 2 weeks of
surgery
-
If you have a light job you will normally be able
to return to this in about 2 weeks; manual labour however will
probably nor be possible for about 6 weeks
-
Full recovery normally takes 3 to 6 months
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