Arthroscopic Subacromial Bursectomy

Arthroscopic subacromial bursectomy is a common component in other operations such as a subacromial decompression or rotator cuff repair, but it can occasionally be undertaken as the primary procedure in the management of a bursitis that has not responded to non-operative treatments.

The aim of the surgery is to initially arthroscopically examine the shoulder to confirm the diagnosis and to make sure that there are no other possible causes for your pain. Once this has been verified, surgery is undertaken with the aim of removing the inflamed bursa, which will have become swollen thereby preventing free movement of the shoulder. It can also cause pain and clicking whilst undertaking fairly routine movements. These symptoms are often referred to as ‘impingement’.

If having removed the bursa, the subacromial space is judged to be too tight to allow free movement of the rotator cuff tendons through the subacromial space, then a subacromial decompression is often undertaken at the same time.

Information for patients / operative Information

Risks and complications

• Infection
• Bleeding
• Nerve injury
• Stiffness
• Continued discomfort

Before admission

• Please bring any X-rays or scans with you to the hospital. This will usually be on a CD disc. These will not be needed if it was Mr Falworth who organised the investigations.
• No food for 6 hours, or drink for 4 hours, prior to surgery.
• Please avoid smoking for 12 hours prior to surgery

In Hospital

• A subacromial decompression is usually performed as a day case procedure or as a single overnight stay.
• Two to three incisions, each approximately 1 cm in length, are made around the shoulder. These are closed with dissolving sutures and Steri-strips.
• Splash proof dressings will be applied but the wound should remain dry for 10 days.
• Prior to your discharge from hospital, a physiotherapist will demonstrate some simple exercises as part of your rehabilitation protocol. These exercises should be undertaken when you’re at home and will help your shoulder recover from the surgery before your out-patient physiotherapy commences.

What to Expect

• Swelling; immediately after an arthroscopic procedure there can be quite a lot of swelling around the shoulder but this settles after approximately 24 hours. A Cryocuff or alternative cold therapy compress, can be helpful in minimising swelling and inflammation. The Cryocuff will usually be issued to you upon discharge
• Pain; an Interscalene Block is often used to reduce immediate post-operative pain. If any discomfort arises once the block has worn off, simple oral analgesics can be taken to manage this. These will be provided to you upon discharge.
• Bleeding; there may be some oozing through the bandages but this should settle soon after the operation.

Post-operative care

• A sling will be provided to help rest the shoulder. This is usually used for the first 7 - 14 days post surgery. To prevent the development of undue shoulder stiffness, the belt that is attached to your sling should be removed 24 hours after your operation.
• The wound should be kept dry for 10 days.
• At ten days the dressing and paper Steristrips can be gently removed. If the wound is ‘dry’ then it is all right to wash the wound, if not, please consult Mr Falworth or your GP for further advice.
• The most important part of your post-operative care is to start an early exercise programme, which the ward physiotherapist will have commenced prior to discharge from hospital. This will maximise the benefit of your operation and will continue as an out-patient.

Post-operative appointments

• You will be reviewed in clinic approximately 3 weeks following your surgery.

Estimated return to functional activities