To chop a shoulder or not to chop a shoulder … that is the question. One of the big issues with rotator cuff surgery is the long recovery time spent in an immobilizer brace. Unfortunately, the more procedures a surgeon performs during the surgery (including the addition of acromioplasty), the longer the recovery time. A study reported in the November 2011 issue of the Journal of Bone and Joint Surgery demonstrated that the addition of acromioplasty to rotator cuff surgery lengthens recovery time.

What is acromioplasty? Acromioplasty is a shoulder surgery that on the surface makes a lot of sense. Like a large number of surgeries that look reasonable on paper, however, acromioplasty has some unintended consequences. Acromioplasty surgery is based on the idea that the shoulder rotator cuff is being pressed upon (impinged) by the bones and ligaments above the rotator cuff. The surgeon will cut these ligaments and shave down a piece of the acromion, which is a bone that sticks out of the front part of the shoulder blade. The major concern with acromioplasty is that these ligaments also stabilize the shoulder. Cutting them leaves the patient with an unstable and sloppy shoulder, which is a slippery slope to shoulder arthritis and other rotator cuff injuries.

Is it really necessary to cut these ligaments, especially considering that this additional procedure may add to a patient’s rotator cuff surgery recovery time? The study reported in the Journal of Bone and Joint Surgery randomized patients into one group in which a rotator cuff tear was repaired, and another group in which the surgeon added an acromioplasty. The results showed no outcome advantage to shaving down the bone and cutting these important ligaments. As might be expected, the additional work and trauma that goes into a procedure such as acromioplasty resulted in longer and more difficult recovery periods for patients.

If you’re planning on getting your rotator cuff tear repaired through surgery, talk to your surgeon before they cut out these important structures. Even before that, consider shoulder rotator cuff stem-cell injections or injections of platelet-rich plasma before undergoing shoulder surgery. These injections can dramatically reduce recovery time, and they provide an excellent alternative for a large number of patients who fall into the “rotator cuff tear” category.

In the uncommon circumstance where there is evidence of severe impingement by an extra large acromion bone or very large bone spurs, acromioplasty may be a good option to help resolve the problem.

 

“Acromioplasty & Rotator Cuff Surgery Recovery Time” first appeared as a post on the Regenexx blog.

Like all medical procedures, Regenexx procedures have a success and failure rate.
Not all patients will experience the same results.

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