Excision of calcific deposit + arthroscopic Subacromial Decompression (ASD)
The subacromial area lies between the acromion (outer end of shoulder blade) and humeral head (upper end of arm bone). The coracoacromial ligament completes the arch. A muscle and fluid filled cushion (bursa) lies between the arm bone and the acromion. Calcium in the rotator cuff tendons can cause bursal inflammation. The pain that you have been experiencing is caused by this inflammation and is typically felt on movements such as reaching and putting your arm into a jacket sleeve.
The Operation:The operation is done by ‘key hole surgery’; usually through two or three 5mm puncture wounds. It involves identifying and removing the calcium from the tendons, cutting the coraco-acromial ligament and shaving away part of the acromion bone. This increases the size of the subacromial area and reduces the pressure on the muscle and bursa allowing them to heal.
General Advice: You will usually be in hospital either for a day or overnight. A doctor/physiotherapist will see you prior to discharge and you will be taught exercises to do and given further advice to guide you through your recovery. You will be given a sling. This is provided purely to keep your arm comfortable. It may be taken off as much as you wish and discarded as soon as possible. You will be encouraged to use your arm. You should be back at work between one and four weeks depending on your job. Your symptoms should be approximately 80% better after three months but may take a year to totally settle.
Complications: As with all surgery there is a risk of some complications. These are rare, but you should be aware of them before your operation.
Complications relating to the anaesthetic, Infection, A need to re-do the surgery, Prolonged stiffness and or pain.