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Shoulder pain is one of the most common physical complaints worldwide, made by 44-65% of the adult population when visiting the orthopedist. Shoulder impingement syndrome or subacromial impingement syndrome, is a condition that occurs when the shoulder’s rotator cuff tendons rub against the top of the shoulder known as the acromion, which is a bony process on the scapula (shoulder blade) that extends laterally over the shoulder joint. External and internal shoulder rotations, as well as lifting heavy objects, cause friction, thus establishing shoulder impingement syndrome as a condition that severely affects the patient’s quality of life.
Lesion patterns are associated with the patient’s rotator cuff (tissue degeneration), shoulder anatomy (high risk groups include patients with structural abnormalities of the acromion or a curved acromion) or both. Inflammation and swelling are typical symptoms of subacromial impingement syndrome and frequently cause rotator cuff tendonitis.

Surgical treatment is necessary in cases of persistent shoulder pain after six weeks of conventional non-surgical treatment, large rotator cuff tears or weakness and physical deterioration of shoulder muscles. Surgery is performed to increase the subacromial space for the shoulder’s rotator cuff tendons (acromioplasty).

Shoulder impingement syndrome surgery (acromioplasty) is performed arthroscopically and is more beneficial compared to an open surgery. Comparative advantages of acromioplasty include preventing an injury of the deltoid muscle, the prospect of removing the small fluid-filled sac that provides a gliding surface for rotator cuff tendons (synovial bursa), simultaneous arthroscopic examination of the glenohumeral joint, and lower risk of infections.
Through small incisions made by the surgeon, a thin viewing scope (arthroscope) and surgical instruments are inserted into the joint in order to remove damaged or inflamed fragments of tissue and other debris from the shoulder. The surgeon will proceed with removing osteophytes (bone spurs that form along shoulder joints), shaving the bone on the underside of the shoulder blade (acromion), and possibly the acromioclavicular joint.

Arthroscopic acromioplasty has a very high success rate and according to published work, a 91% recovery rate of tendon strength. On the same day of the surgery, patients can leave the hospital after the shoulder is immobilized. During the first week, a shoulder sling is necessary.   In the first 48 hours, physiotherapy sessions are initiated and typically involve passive motion exercises to keep the shoulder from tightening up.
Based on the patient’s age and level of physical activity, return to daily activities is an estimated 2 weeks after the surgery. In cases of patients that perform heavy manual work, an 8 to 12 weeks period is necessary for recovery. Complete restoration of the shoulder function requires almost six months.  

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