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Question:
i was told that i need surgery on my shoulder to remove a bone spur under my acromion and to remove my empty bursa.plus another boner bone spur,down more on the clavical.what is the name of surgery that wiil be performed to do this and how much longer after surgery whould i be back to full range of motion for full duty,iam a laborer and do alot of driveing.
Question submitted by:
cmgomesme@cs.com
| Dr. Hasan |
Dr. Hasan is an orthopaedic surgeon specializing in shoulder, elbow, and general orthopaedic problems. Dr. Hasan has received the M.D. degree and a Ph.D. degree in biomedical engineering, both from Vanderbilt University. He completed residency training at Rush-Presbyterian-St. Luke's Medical Center in Chicago followed by fellowship training at both the University of Washington and the Texas Orthopaedic Hospital in Houston.
Dr. Hasan has published a number of articles in peer-reviewed journals and presented his research efforts at national and international orthopaedic conferences.
Dr. Hasan’s areas of interest include: arthroscopic and open surgery of the shoulder, elbow, and knee as well as joint replacement surgery. He currently practices at Cincinnati Sportsmedicine and Orthopaedic Center.
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Answer:
The treatment that you are describing is called a subacromial decompression and distal clavicle excision. The subacromial decompression can be performed either arthroscopically (through small incisions through which instruments are passed) or open (using a small incision). This involves removing the bursa (which is usually inflamed) and sometimes (though not always) removing a bone spur on the undersurface of the acromion (that may contribute to your shoulder symptoms). The distal clavicle excision (or Mumford procedure) involves removing a small amount of bone from the outer end of the clavicle or collar bone. The above surgery is usually done for a condition called "impingement", which can be thought of as an early stage of rotator cuff disease. In impingement, the rotator cuff becomes irritated when the arm is placed in certain positions such as overhead activity. The rotator cuff is usually not torn completely, but it may be frayed or partially torn. Impingement usually responds to anti-inflammatories, activity modification, and physical therapy aimed at stretching the shoulder, but sometimes surgery is needed. If the AC joint (joint between the acromion and distal clavicle) is arthritic, and the arm is painful when it is brought across the chest at shoulder level towards the opposite shoulder, then it may indicate that the AC joint is painful as well. In such cases, shoulder pain may improve after a distal clavicle excision. The distal clavicle excision may be performed arthroscopically or using an open technique. In any case, the surgeon should be prepared to fix a rotator cuff tear, if one is identified at the time of surgery.
In terms of rehabilitation, assuming there is no rotator cuff tear that requires repair, shoulder motion and exercises are allowed immediately in most cases. Usually by six weeks after surgery, considerable motion has been achieved. Strengthening may be initiated right away, but usually begins six or more weeks afterwards. Driving is usually permitted by six weeks, but heavy labor (especially overhead) may take much longer. It all depends on the exact surgery that is performed, the method (open, arthroscopic, or combined) and the findings (complete or partial rotator cuff tear, or no rotator cuff tear).
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