Arthroscopic decompression and acromioplasty
This is an operation usually performed using arthroscopy. The shoulder joint is visualised through a viewing portal at the back of the shoulder, and the evidence for rubbing or fraying sought. If there is a rotator cuff (RC) tear (see below) this is dealt with according to the symptoms in the clinic, and the quality of the tendon as seen on a scan such as an ulstrasound scan (USS).
The bursa is removed using a thermal probe, and the shape of the acromion smoothed if it is abnormal using a powered burr. The operation takes about 45 minutes. The arm is rested in a sling for up to three weeks, and an exercise programme (the weak and smooth programme or the stiff programme depending on the state of the RC tendons) is started. Exercise should continue over a three-month period, and the success rate of this operation, when carefully chosen, is about 95%.