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Acromioplasty is a surgical procedure performed on a patient who is experiencing pain and weakness in the shoulder caused by a condition known as impingement syndrome. Tendons pass under the acromion bone at the top of the shoulder blade, and if these tendons are injured or inflamed, they can rub on the underside of the acromion. The acromioplasty is performed to smooth or remove any rough pieces of the acromion to create more space for the tendons to move.
Athletes who participate in sporting activities that involve overhead movement of the arm and shoulder may develop impingement syndrome. Inflammation of the tendons in the shoulder, especially the rotator cuff, can also be caused by overuse or repetitive activities, such as painting or lifting. If the patient experiences persistent pain that is not relieved with anti-inflammatory agents, rest, or ice, the surgeon may want to perform an acromioplasty.
The surgeon may first order a series of x-rays to view the bones of the shoulder. Other tests, such as magnetic resonance imaging (MRI), may also be ordered to give a view of any fluid present in the shoulder. If the surgeon feels the acromioplasty will benefit the patient, the procedure can be performed as either an open surgery or as an arthroscopic surgery.
Open acromioplasty is performed by making an incision on the front of the shoulder to give a full view of tendons and muscles. The surgeon may remove the front portion of the acromion bone and shave any ridges off the underside of the bone to give it a smooth surface. Range of movement can then be evaluated while the incision is open. This open surgery may require a longer recovery time, but it gives the surgeon more access to the shoulder area.
Acromioplasty can also be performed as an arthroscopic procedure in which a few small incisions are made in the shoulder area. An arthroscope, which contains a camera and a light source, is inserted to view the acromion and the shoulder joint. Surgical instruments are also inserted to scrape or remove a portion of the acromion. This arthroscopic procedure is less invasive and the recovery time is shorter.
A patient should expect to spend from a few hours to overnight at the hospital after an acromioplasty procedure. There may be pain and swelling that can be treated with ice and pain medication. The surgeon may also prescribe physical therapy exercises that would begin a day or two after surgery. It generally is important for a patient to follow the recommendations of the surgeon and physical therapist in order to return full range of motion to the shoulder.