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What is Subacromial Decompression?

Subacromial decompression (also called acromioplasty or shoulder decompression) is a surgical procedure that is typically performed arthroscopically in order to treat shoulder impingement syndrome (SIS) by removing a piece of bone from the scapula (shoulder blade).

Key statistics about Subacromial Decompression

  • Approximately 4.5 million patient visits that are associated with shoulder pain occur annually in the United States[1]
  • Up to 65% of all shoulder problems are associated with shoulder impingement syndrome[2]
  • Approximately 79% of individuals who undergo arthroscopic subacromial decompression experience successful results[3]

Expert Insights

Subacromial Decompression Symptoms - J. Field Scovell, III, MD

Shoulder Anatomy

The shoulder is a ball-and-socket joint formed by three bones: the humerus, the scapula, and the clavicle. The acromion is a bony process on the upper outer edge of the scapula. The acromion joins the clavicle to create the acromioclavicular joint (AC joint).

3D rendering of the shoulder with colorized regions highlighting its anatomy

The rotator cuff is made up of a group of four tendons and muscles that surround the shoulder joint. These muscles are the subscapularis, the supraspinatus, the infraspinatus, and the teres minor, and together they work to stabilize the joint and move the arm.

Two 3D renderings of the shoulder showing its anterior and posterior views along with labels pointing out the supraspinatus, subscapularis, infraspinatus, and teres minor

Why is Subacromial Decompression performed?

Subacromial decompression is primarily performed to address pain, weakness, and loss of joint mobility due to shoulder impingement syndrome (SIS). Shoulder impingement is a result of too little space between the acromion and the rotator cuff tendons, causing the tendons to rub against the underside of the acromion, leading to tendon damage.

Shoulder impingement syndrome is caused by:

  • Swelling of the rotator cuff tendons due to traumatic injury, repetitive movement, or as a normal consequence of aging
  • Bone defects of the acromion such as bone spurs

Subacromial decompression may be necessary to remove a portion of the acromion in order to create more space between the bone and rotator cuff.

Distal clavicle resection also may be recommended if there is damage to the acromioclavicular joint. Additionally, full or partial rotator cuff repair can be necessary, depending upon the extent of tendon damage.

Who needs Subacromial decompression?

Shoulder impingement syndrome is most commonly the result of repetitive movement from participation in throwing or overhead sports, or by traumatic injury such as a fall.

Subacromial decompression is a surgical procedure that may be performed to address shoulder impingement syndrome that cannot be treated with nonsurgical measures.

How is Subacromial Decompression performed?

  • The surgeon will make small incisions around the shoulder joint and the arthroscope will be inserted into one of the incisions.
  • Saline solution is pumped into the joint to expand it and improve visualization.
  • Images from the arthroscope are sent to a video monitor where the surgeon can see inside the joint.
  • Bone from underside of the acromion is removed using a surgical bur.
  • Finally, the saline solution is drained, instruments are removed, and the incisions are closed using sutures.

What are the risks of Subacromial decompression?

It is uncommon to experience serious complications from subacromial decompression. Potential risks may include:

  • Infection
  • Nerve and blood vessel damage
  • Pain
  • Shoulder stiffness

How long does it take to recover from Subacromial Decompression?

  • 24 hours after surgery
    Most patients are able to return home the same day as their procedure, and pain medication may be prescribed. A physical therapy routine will be established by the surgeon and physical therapist. A sling may be provided, but it is important that prescribed exercises are followed in order to prevent the development of any weakness or stiffness.
  • 2 weeks after surgery
    Any non-dissolvable sutures are removed and bruising and swelling begin to subside.
  • 4-6 weeks after surgery
    Most patients are able to discontinue use of the sling and resume most daily activity.
  • 8-12 weeks after surgery
    Most patients are fully recovered from subacromial decompression.

What are the results of Subacromial Decompression?

Subacromial is a safe and effective procedure performed to alleviate pain and restore shoulder function to patients suffering from shoulder impingement syndrome. Approximately 79% of individuals who undergo arthroscopic subacromial decompression experience successful results[3].

Mather III, R.C., Koening, L., Acevedo, D., Dall, T.M., Gallo, P., Romeo, A., Tongue, J., & Williams Jr., G. (2013). The Societal and Economic Value of Rotator Cuff Repair. The Journal of Bone & Joint Surgery. 95(22), 1993-2000.
Nizam Siron, K., Mat Lani, M.T., Low, C.L., & Row, R.Y. (2021). Arthroscopic Subacromial Decompression in the Treatment of Shoulder Impingement Syndrome: A Prospective Study in Malaysia. Cureus. 12(11), e19254.
Jaeher, M., Berndt, T., Rühmann, O., & Lerch, S. (2016). Patients With Impingement Syndrome With and Without Rotator Cuff Tears Do Well 20 Years After Arthroscopic Subacromial Decompression. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 32(3), 409-415.
Last edited on February 7th, 2024 6:08 pm