Shoulder arthroscopy acromioplasty or debridement

Procedure

  • General anaesthetic and local infiltration

  • Usually one night in hospital

  • Small arthroscopic (keyhole) incisions to visualise the shoulder structures and perform the surgery

  • Acromioplasty involves clearing the bursa, trimming the undersurface of the acromion and any bone spurs, and removal of calcium (if present)

  • Additional debridement (‘tidying up’) may be performed to address other soft tissue changes or loose fragments/flaps

  • A light sling is commonly applied depending on the procedure

Day one post-op

  • Usually the sling is used for comfort when up and about

  • May shower without sling on and use arm gently as comfort allows

  • Pendulum exercise - 30 seconds twice a day

Pendulum exercise

You can see a video demonstration here: https://www.youtube.com/watch?v=S0blH3d9xyI

  1. Lean forward and hang your arm

  2. Swing your arm in a gentle circle, building towards a 30 centimeter diameter.

You can do this once or twice per day for approximately 30 seconds, e.g. shower time and dressing.

Rehabilitation

  • Sling for comfort when up, usually for 5 days then discontinue the sling

  • Use arm in comfort range below eye level

  • Don’t lift heavier than 2 kilograms initially and avoid rapid movements

  • After 3 - 4 weeks of light use, more structured rehabilitation can commence

Rehabilitation and physiotherapy guidelines

  • Initially work on posture, scapula control, range of motion

  • Normalise patterns of use for activities of daily living

  • Light theraband inner-range strengthening when 80% range of motion is re-established (usually around 6 weeks post-surgery)

  • Usually gym-based strengthening can commence approximately 8 weeks post surgery

  • Proprioception and sport-specific rehabilitation once sufficient strength is regained

  • Generally the earliest return to more challenging shoulder activities is 3 or more months post surgery

  • Overall improvement will continue to for 12 – 18 months after surgery

Return to work guidelines

Often the initial return to work is part-time hours and modified duties, gradually building up.

  • Sedentary work with arm in sling: 7 to 10 days.

  • Light two handed desk height duties and driving: 10 to 14 days.

  • Medium lifting below eye level: 6 weeks.

  • Heavy work: may be 2 to 3 months (depending on progress).