Arthroscopic Bursectomy & Acromioplasty

Q1. What is an arthroscopic bursectomy and acromioplasty?

An arthroscopic bursectomy and acromioplasty is a minimally invasive surgery performed to relieve shoulder pain caused by shoulder impingement syndrome. During this procedure, a surgeon uses a small camera (arthroscope) and specialized instruments through tiny incisions to remove an inflamed fluid-filled sac (the bursa) and shave down any bone spurs on the underside of the shoulder blade (acromion). This creates more space for the rotator cuff tendons to move freely without pinching.

Q2. What is subacromial impingement syndrome, and how does it cause pain?

Subacromial impingement syndrome occurs when the tendons of your rotator cuff and the surrounding bursa are pinched (impinged) between the head of your upper arm bone (humerus) and the front edge of your shoulder blade (acromion). When you raise your arm, this narrow space gets even smaller, causing friction, inflammation, and pain, especially during overhead movements.

Q3. What is the difference between a bursectomy and an acromioplasty?

A bursectomy and an acromioplasty are two distinct techniques often performed together. A bursectomy is the removal of the inflamed, swollen subacromial bursa (the cushioning sac). An acromioplasty involves shaving or reshaping the underside of the acromion bone to remove rough edges and bone spurs, permanently widening the space for your shoulder tendons to glide smoothly.

Q4. When is surgery recommended for shoulder impingement?

Surgery is usually recommended if you have chronic, severe shoulder pain that has not improved after several months of conservative treatment. Non-surgical options typically include:

• Rest and activity modification
• Physical therapy and targeted exercises
• Anti-inflammatory medications (NSAIDs)
• Corticosteroid injections

If these do not provide lasting relief and pain continues to interfere with daily life or sleep, surgery is considered.

Q5. How is the arthroscopic procedure performed?

The surgery is performed using arthroscopy, which means the surgeon makes a few tiny skin incisions (portals), each less than a centimeter long. A small camera (arthroscope) is inserted into one portal to project clear, magnified images of the shoulder joint onto a monitor. The surgeon inserts miniature instruments through the other portals to remove the inflamed bursa and shave down the bone spurs.

Q6. What are the benefits of arthroscopic surgery over open surgery?

Compared to traditional open surgery, arthroscopic surgery offers several significant benefits:

• Tiny incisions that result in less scarring and less damage to surrounding healthy muscles.
• Less post-operative pain and swelling.
• A faster recovery timeline and a quicker return to normal daily activities.
• A lower risk of complications, such as infection or wound issues.
• The procedure is almost always performed on an outpatient basis, meaning you go home the same day.

Q7. What type of anesthesia is used for this procedure?

Typically, the surgery is performed using a combination of a regional nerve block and general anesthesia. The regional nerve block temporarily numbs your shoulder and arm to keep you comfortable during and immediately after the surgery. General anesthesia ensures you are asleep and pain-free throughout the entire procedure.

Q8. How long does the surgery take, and will I need to stay in the hospital?

The actual surgical procedure typically takes between 30 and 60 minutes, depending on the complexity and whether other issues (like minor rotator cuff tears) are addressed. Since it is an outpatient procedure, you will spend a couple of hours in the recovery room as your anesthesia wears off, and you can return home the same day.

Q9. Do I need to wear a sling after surgery, and for how long?

Yes, you will need to wear a sling after surgery, but usually only for comfort and protection. Because the tendons are not typically repaired or cut during a simple bursectomy and acromioplasty, you do not need strict, long-term immobilization. Most patients wear the sling for 1 to 2 weeks, using it primarily when out in public or sleeping to prevent accidental jarring of the shoulder.

Q10. How should I manage my pain at home after the surgery?

Pain management involves several key strategies:

• Use your prescribed pain medications as directed by your surgeon, especially during the first few days.
• Regularly apply ice packs to your shoulder for 15-20 minutes at a time to reduce swelling and numb the pain.
• Keep your arm supported in the sling when resting.
• Follow a schedule for taking over-the-counter anti-inflammatory medicines if approved by your doctor.
• Sleep in a semi-reclined position to minimize pressure on the shoulder.

Q11. What is the best way to sleep comfortably after the procedure?

Sleeping flat on your back can put extra pressure on your healing shoulder and increase pain. For the first few weeks, most patients find it much more comfortable to sleep in a semi-reclined position (at a 45-degree angle) in a recliner chair or propped up with several pillows in bed. Placing a small pillow under your elbow or behind your shoulder can also help support the arm and prevent it from pulling backward.

Q12. When can I start physical therapy and movement?

Gentle, passive range-of-motion exercises (where your arm is moved for you) and pendulum exercises are often started within the first few days after surgery to prevent stiffness. A formal physical therapy program usually begins within 1 to 2 weeks. The initial focus is on restoring full mobility, followed by progressive strengthening of the rotator cuff and shoulder blade muscles.

Q13. When can I return to driving and normal daily activities?

You can generally return to driving once you are completely off prescription pain medications, have sufficient strength and control of your arm, and feel confident in steering safely—usually around 1 to 2 weeks post-op. Light daily activities, such as writing, typing, and eating, can be started within a few days, keeping your elbow close to your body.

Q14. What are the potential risks and complications of this surgery?

Although arthroscopic bursectomy and acromioplasty is very safe, all surgeries carry some risks. Potential complications include:

• Shoulder stiffness (sometimes called frozen shoulder).
• Persistent pain if there is underlying tendon damage or slow healing.
• Temporary numbness or weakness in the arm from the nerve block.
• Rare risks like infection, bleeding, or blood clots.

Your surgical team takes extensive precautions to minimize these risks.

Q15. What is the long-term success rate and recovery outlook?

The long-term success rate is highly favorable, with about 85% to 90% of patients experiencing significant pain relief and improved shoulder function. The overall recovery timeline varies, but most patients achieve substantial recovery within 2 to 3 months, with continued improvement in strength and flexibility for up to 6 months. Active participation in physical therapy is key to achieving the best possible outcome.

We encourage you to write down any specific questions you have and discuss them thoroughly with your surgeon, doctor, or physical therapist. They are your best resource for personalized advice and care.

Disclaimer: This brochure provides general information and is not a substitute for professional medical advice. Always consult your doctor or qualified healthcare provider with any questions you may have regarding your specific medical condition and treatment plan.