Subacromial Decompression Surgery

Subacromial decompression surgery – not the answer

Today I’ll like to review a recent study that was published on a type of shoulder surgery called subacromial decompression.  This surgery is done to treat a condition called shoulder impingement. Shoulder impingement occurs when a bone (called the acromion) can impinge on a part of the rotator cuff.  Over time, this can cause damage and inflammation to the rotator cuff. A subacromial decompression is when the acromion bone is shaved off and ligaments are released so that the impingement on the rotator cuff no longer occurs.  Doesn’t sound too bad right? The problem is that messing with the ligaments and bone can cause further instability of the shoulder and lead to greater problems done the road.

A recent study that was published in January 2019 in the British Journal of Sports Medicine confirmed this.  The study was a systematic review with meta-analysis. This means that the authors took a look back at many randomized controlled trials (the gold standard in medical research) that were done on this surgery and summarized the results. The conclusion? Subacromial decompression surgery provided no important benefit compared with placebo surgery or exercise therapy, and probably carries a small risk of serious harms.  So, we can say goodbye to this surgery as an effective treatment. However, it will likely continue to be performed as long as insurance will cover the procedure. What does this mean for you? Avoid a subacromial decompression surgery based on this data and focus on strengthening the shoulder and creating more stability.  There are multiple options for this including physical therapy, restoring the normal alignment of the shoulder and cervical spine, and potentially treating the ligaments and/or tendons of the shoulder with your own platelets or stem cells. Also, you may want to have your neck examined as well since shoulder pain can often be referred form the nerves or bones in the neck.  The important point is to find out what works for you, do your homework, and consult with a physician who is an expert in musculoskeletal medicine and understands the whole body!

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