Acromioplasty Surgery - Indications, Purpose, Risks & Recovery

An Acromioplasty is a surgical procedure that involves shaving the acromion (a part of the shoulder bone) to relieve and treat shoulder pain. An acromion is a triangular-shaped bone found in both shoulders. It extends towards the shoulder joint and forms an acromioclavicular joint and the collarbone. It is also commonly known as a subacromial decompression. 

Due to the repetitive motion of the shoulders, the surface of the acromion bone, along with nearby tendons, gets damaged. Therefore, the surgeon creates more space under the acromion during the surgery by removing some parts of the bone and nearby affected tendons. It helps in easy movement of the acromion bone and helps in relieving the symptoms. 

Procedure Name	Acromioplasty
Alternative Name	Subacromial decompression
Conditions Treated	Extreme shoulder pain, Reduced activity in the shoulder, Weakness in the shoulder and the arm, Acromioclavicular joint injuries
Benefits of Surgery	Minimally Invasive,  Lower the rate of recurrent pain and tears.
Treated By	Orthopaedic Surgeon

The shoulder in the human body is made up of the three bones which are:

1. The Scapula: It is also known as the shoulder blade. The scapula helps stabilize the upper arm bone, which sits in the socket on the outer edge of the shoulder blade.
2. The Clavicle: The collar bone also known as collarbone supports and keeps the arms in place when away from the body or under movement. 
3. The Humerus: The bone of the upper arm is called the humerus. It allows the arm's large range of motion.

The shoulder is referred to as a singular joint. However, it is made of 4 joints which are:

1. Glenohumeral Joint: It is one of the main joints of the shoulder and is commonly known as the glenoid cavity. It is formed by the rounded top head of the humerus and the rounded socket of the scapula. 
2. Acromioclavicular Joint: It is also known as the gliding synovial joint as it allows bones to move up and down, side by side, and diagonally. 
3. Sternoclavicular Joint: It is situated where the clavicle meets the breastbone (sternum). This joint connects the upper arm to the rest of the body and facilitates a number of the movements. 
4. Scapulothoracic Joint: It is situated where the scapula glides against the ribcage at the back of the body. 

An acromioplasty is performed when other physical and medicinal methods fail to provide relief from the inflammation and pain in the shoulder. The conditions that may require acromioplasty are bursitis, arthritis, bone spurs and rotator cuff injuries. The doctor performs the acromioplasty when a person is suffering from:

1. Extreme shoulder pain
2. Reduced activity in the shoulder
3. Weakness in the shoulder and the arm.
4. Acromioclavicular joint injuries due to constant strain, overuse of the acromion bone, and damage to the cartilage. 

When acromioclavicular joint injuries occurs, the acromion bone comes in direct contact with the tendons, causing serious damage to the tendon resulting in pain and swelling.

The doctor performs the acromioplasty in the following steps:

1. Firstly, the doctor will give you general anesthesia to make you calm and sleep during the surgery.
2. Then the doctor will clean the shoulder and make a small incision around the shoulder.
3. Then, the surgeon inserts a small, flexible tube with a camera attached to it called an arthroscope through an incision made. 
4. The doctor places the arthroscope in the subacromial space in the joint. and uses it  to evaluate the joint and look inside the shoulder.
5. The surgeon makes another incision on the shoulder, and the acromion bone and the acromioclavicular ligament are exposed using special surgical instruments.
6. The inflammatory site of the acromion is resected using the specialized motorized cutter that simultaneously cuts the bone and removes the debris.
7. Once the acromion is thinned and the bone spur is completely removed, the surgeon checks for the tendons to have enough space during the movement.
8. Then the surgeon removes the arthroscope from the incision.
9.  Finally, the incisions are covered with the help of the sutures and stitches.

Before the Acromioplasty

1. An orthopedic surgeon will perform the surgery. The doctor will explain to you how to prepare for the surgery.
2. Your surgeon will explain the complete procedure before the surgery. You can ask or call the doctor anytime if you have any doubts or questions regarding the surgery.
3. Avoid smoking and drinking alcohol at least a week before the surgery, slowing down recovery. Also, kindly ask your friend or relative for a ride back from the hospital to home after the surgery. 
4. The doctor may also ask you to stop taking a blood thinner like ibuprofen or aspirin a week before the surgery. In addition, avoid drinking or eating anything after midnight a day before the surgery. 

On the day of the Surgery

1. Kindly reach the hospital at least 30 minutes before the time. 
2. Once you reach the hospital, the doctor may perform some imaging tests and blood tests. 
3. The doctor will ask to sign the consent form to permit the surgery. 
4. The nurse will ask yjewelleryemove the jewelry (if any) and change it to the hospital gown.
5. You will then be taken to the operation theatre.

After the Acromioplasty

1. It takes, on average, about half an hour to 1 hour to complete the surgery. 
2. Once the surgery is completed, you will be shifted to the recovery room, where medical staff will monitor the vitals. 
3. After you wake up, the nurse will help you with your walk. 
4. You will be discharged from the hospital on the same day.
5. The doctor will prescribe you painkillers and antibiotics at the time of the discharge. 
6. You may need to wear the shoulder brace or arm sling to protect the shoulder and immobilize the joint movement. 

First follow-up with a doctor after the surgery

1. You will have a first follow with the doctor after 10 to 15 days from the day of the discharge. The doctor will perform some imaging tests and blood tests on the day of the first follow-up to check for the recovery and complications, if any.
2. If everything is fine, the doctor will remove the dressing. The surgeon may recommend wearing a sling to support the shoulder and the arm. You should also avoid any heavy lifting and exercises during the recovery. 
3. Complete recovery from surgery may take around 2 to 3 months. The doctor may ask you to participate in a rehabilitation program or physical therapy.
4. The physiotherapist will help you with exercises to regain strength, flexibility, and mobility back in the shoulder and the arm.

An acromioplasty is a minimally invasive surgery. It is a safe and effective procedure performed by a team of experienced doctors. However, there are some risks and complications associated with acromioplasty are:

1. Increased pain
2. Excessive bleeding
3. Joint stiffness
4. Injury to the nearby tissues or nerves
5. Infection at the site of operation
6. Reaction to anesthesia
7. Inflammation and redness
8. Hematoma (swelling caused by blood clotting)
9. A fracture in the acromion bone
10. Seroma formation

The cost of Acromioplasty ranges from ₹80,000 to ₹1,60,000. The cost varies based on the following factors:

1. Type of Acromioplasty surgery
2. Age of the patient
3. The medical condition of the patient
4. The type of hospital facility availed - individual room or shared.

Procedure Name	Cost Value
Acromioplasty	₹80,000 to ₹1,60,000