Acromioplasty is a surgical operation, the objective of which is to plan part of the shoulder bone, the acromion. This in order to reduce the pain in the tendons of the shoulder, which rub against the acromion repeatedly. The operation is under general anesthesia, the patient regains the amplitude of his shoulder within three months.

Acromioplasty aims to plan the acromion to reduce its friction on the tendons of the shoulder.

The acromion, end of the shoulder

The acromion is the bone that lines our right and left shoulders. It can be felt at the border between the collarbone, the scapula and the humerus, the upper arm bone. It is a bony protrusion in the shape of a triangle. Some acromions are by nature larger than average, they are called aggressive acromions.

During a “dislocation of the shoulder”, it is the acromion which ignited in dislocation.

Acromioplasty: planing the acromion

The acromioplasty operation will therefore aim to “plan” the acromion, in the sense of reducing its thickness using targeted surgery.

It is in fact under the acromion that the muscles and tendons of the shoulder are grafted. With a wide movement of the shoulder, these tendons may touch the acromion if there is not enough space, for example if a bone growth is developing. If this happens, it is no longer possible to lift the arm without feeling discomfort or pain, which can lead to long-term complications from the repetition of the movement.

Surgery can therefore make it possible to put an end to this risk of friction, quite simply by reducing the size of the acromion, and therefore increasing the space available for the muscles and tendons of the shoulder.

Prepare before the operation

Shoulder acromioplasty does not require any other recommendations than those inherent in any operation under anesthesia. Your doctor will accompany you on these recommendations.

The operation in detail

Shoulder acromioplasty takes place under General anaesthesia. It is based onarthroscopy, that is to say that one does not “open” the shoulder, instead one makes fine incisions to place a camera there, which limits the discomfort for the patient.

• The shoulder area is disinfected
• Two five-millimeter incisions are made in the patient’s shoulder, in “hollow” areas. 
• The surgeon begins by inserting an arthroscopic device, a camera allowing to view the inside of the shoulder. This camera does not drill a bone, it is simply inserted into a shoulder cavity (subacromial sliding space).
• The first step is to clean this space between the acromion and the tendons. Indeed following the pain, many tissues in a state of inflammation occupy the space. They are cleaned with a tool using an electric current. Above all, this phase frees up space for the next step.
• Then, we introduce a small metal rod at the end of which is placed a motorized cutter. A device used to “file” the bony outgrowth of the acromion, to make it smooth again. Debris from the bone is immediately sucked up by the rod.
• A post-operative x-ray confirms that the space between the acromion and the tendons has indeed been increased.

Risks of tendon ruptures

In the case of a bone growth, at the level of the acromion, the space between the scapula and the acromion is reduced. The tendons in the shoulder eventually rub against the acromion, causing inflammation and even pain. tendon ruptures. To avoid these ruptures, acromioplasty of the shoulder is recommended as a preventive measure. The goal is to destroy the bony growth, and bring the acromion back to its original state.

Acromion differs

There are different types of acromions. Some of them are too curved, or too hooked. We call them aggressive acromions, because they assault the tendons of the shoulder and weaken them. The acromioplasty of the shoulder makes it possible to repair these acromions to give them a more “passive” shape.

Shoulder pain

With age, the shoulder joint deteriorates and sags. The acromion bone rubs more and more with the scapula, leading to the formation of an outgrowth (see above). Pain appears, as well as difficulty moving the shoulder.

After the operation

The patient resumes normal activities the next day. A splint will sometimes be placed on the affected arm to avoid moving it directly after the operation.

Re-education

The patient will go through a phase of rehabilitation of the shoulder, as soon as the operation is completed. It is indeed necessary to gradually find the original sensations, with the help of amplitude exercises, shoulder movements, and progressive bodybuilding.

This rehabilitation phase lasts an average of three months.