You are here

Subacromial Decompression 29826

 
CPT Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:

Subacromial Decompression CPT

 

Subacromial Decompression Indications

 Subacromial Decompression Contraindications

  •  Infection

Subacromial Decompression Alternatives

  • Conservative care (NSAIDs, physical therapy, subacromial injection)

Subacromial Decompression Pre-op Planning

Subacromial Decompression Technique

  • Ensure they have full internal rotation pre-operatively, if not consider Posterior Capsular Contracture as cause of pain and consider posterior capsular release. (Ticker JB, Arthroscopy 2000;16:27-34).
  • Perform Shoulder Arthroscopy
  • Place scope into subacromial space via posterior portal incision. The subacromial space is largest and most easily entered beneath the anterolateral corner of the acromion.
  • Lateral portal under the anterior half and parallel to the acromion.
  • Perform full bursectomy to relieve any sources of crepitation
  • In subacromial space visualize CA ligament, anterior and lateral margins of acromion, AC joint.  Pts with impringement will have fraying of CA ligament
  • Release CA ligament.  BE wary of acromial branch of thoracoacromial artery bleeding, and stop with cautery if it occurs.  Do not release CA ligament in patients with RTC-deficient shoulders.
  • Perform initial acromioplasty using a burr through the lateral portal, then complete acromionplasty with a posterior cutting block technique.
  • Evaluate undersurface of the distal clavicle for impinging osteophytes. Do not violate AC joint. (Fischer BW, Arthroscopy 1999;15:241-8). If impinging osteophytes are present consider Distal Clavicle Resection
  • Consider transverse humeral ligament release(Ruotolo C, Arthroscopy 2002;18:65-75), Distal Clavicle Resection, Biceps Tenodesis or tenotomy based on pre-operative evaluation.

Subacromial Decompression Complications

Subacromial Decompression Follow-up care

  • Post-op:
  • 7-10 Days:
  • 3 Weeks:
  • 6 Weeks:
  • 2 Months:
  • 3 Months:
  • 6 Months:
  • 1Yr:

Subacromial Decompression Outcomes

  • 81% good to excellent results at 6-10 years. (Stephens SR, Arthroscopy 1998;14:382).

Subacromial Decompression Review References

 

 

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer