Shoulder surgery: subacromial decompression

[Fast Twitch Fiber]

Has anyone had this? I'ce been battling RC impingement for some time. I have chronic tendonitis and bursitis. The surgeon said I have a large bone spur. I'm considering going under the knife. Has anyone here had good results? Bad results? I'm trying to weigh the pros and cons of it. I've been through PT, ART, and had a cortisone injection with limited success.

 

[bigtbone]

I participated in several SAD procedures as a med student. Did the doc say you "might" have a bone spur which is causing the impingement or did he say you "do" have a bone spur visable on X-ray?

Basically, aside from anatomical abnormalities, the most common cause of impingement syndrome is that repetitive activity causes breakdown in the rotator cuff muscles and results in tendinitis. The resulting weakness in the rotator cuff muscles causes loss of effective movement of your shoulder joint. This causes impingment of the cuff muscles under the acromion (pinching muscle against bone), enhancing the pain and inflammation.

Here is some info from my PDA for you:

In those <25 years old, impingement is usually related to laxity caused by instability.

In those 25 to 40 years of age, impingement is usually due to overuse of the rotator cuff.

In those over 40 years of age, it is caused by use of the cuff muscles over threshold. This may result in partial or full-thickness tears, in additioin to impingement.

Anterior acromioplasty (also called decompression): the acromium is "shaved" to allow more space for the rotator cuff. It is used only if conservative measures fail. There is a less favorable outcome in younger (50% success rate) than older athletes.

I think that if you have an identifiable anatomic abnormality (such as a bone spur) which is creating the impingement, the probability of success would be greater than the normal rate. This is because the normal success rate includes all SAD procedures, many of which have no known culprit for the impingement prior to surgery. If you have a known bone spur, chances are it is the problem and decompression would fix it.

 

[Fast Twitch Fiber]

Thanks for the information. The surgeon said the bone spur was "significant" and he showed it to me on the X-ray so it definitely exists. I asked him straight up if the bone spur was definitely the cause of the problem and he gave me the answer that "nothing was definite". It wasn't what I wanted to hear but I guess it's probably true. I'm 32 years old. My only fear is that something would happen during the operation that would make my shoulder worse. He mentioned trying another injection of a pain medication and continuing with physical therapy.

 

[bigtbone]

I would have the procedure done then. The risks of arthroscopic decompression alone are essentially zero except for that associated with the anesthesia. It is a very simple operation. Get the sucker shaved off and I guarantee you'll have less inflammation.