Pre-operative information

Sub-acromial decompression and excision of acromioclavicular joint

X-Ray of a Shoulder showing narrowing of the Acromioclavicular Joint (Arrow)

You have been diagnosed with both impingement and also painful degenerative change of the joint between the collar bone and the acromion (part of the shoulder blade - the ACJ)

This may be managed with injections. Often an injection is the first treatment, both to help manage the symptoms and also to confirm that the ACJ is contributing to the symptoms.

You have agreed  that the next sensible step is a keyhole operation to treat this condition.

In addition to a sub-acromial decompression you will also have the painful joint widened by partial excision to prevent the arthritic bones from rubbing together.

The aim of the surgery is to improve the pain around the shoulder and help to restore the function of the shoulder.

There are obviously risks of the operation but these are generally small. They include pain, infection, stiffness, scarring and incomplete resolution of symptoms. The shoulder is often painful for several weeks but normally by 6 weeks things are improving. The ACJ itself may remain tender for several months.

This operation is usually performed as a Daycase with no need for an overnight stay.

It is normally performed under general anaesthetic (with you asleep) and the anaesthetist may also block the nerves of the arm.

The operation is performed though several small incisions around the shoulder and involves removal of the inflamed bursa and bone spur with the additional step of excising part of the painful joint to widen it.

The procedure takes 45-60 mins

Wounds are usually closed with dissolvable stitches

After the operation:

  • You will see the physiotherapist prior to your discharge. They will show you how to release your arm from the sling and do specific exercises with the arm.

  • It is important to keep the arm moving and painkillers should be taken to facilitate this

  • You will have a follow-up appointment at 2 weeks The stitches will be trimmed prior to seeing me

  • You should expect significant recovery by 6 weeks but will continue to recover for 3-6 months

Return to Functional Activities:

Driving                                       2 weeks 

Swimming                                   As pain allows from 2-4 weeks

Golf                                             6 weeks

Repeated Overhead Activities    3 months

Lifting                                         As able

Work                                           Sedentary - As able

Manual - 6 weeks, may need to modify activity for 3 months