Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release
CPT4 code
Name of the Procedure:
Acromioplasty or Acromionectomy, Partial, with or without Coracoacromial Ligament Release
Summary
Acromioplasty, also known as partial acromionectomy, is a surgical procedure that involves the reshaping or removal of part of the acromion, a bony prominence of the scapula (shoulder blade). The procedure often includes the release of the coracoacromial ligament to alleviate impingement and associated pain in the shoulder.
Purpose
Acromioplasty is primarily performed to treat shoulder impingement syndrome, where the rotator cuff tendons are compressed during shoulder movements. The procedure aims to create more space for the tendons, reducing pain and improving shoulder function.
Indications
- Persistent shoulder pain that does not respond to conservative treatments like physical therapy or medication.
- Symptoms of shoulder impingement, such as pain with overhead activities, muscle weakness, and reduced range of motion.
- Diagnosis of rotator cuff tears potentially aggravated by bony spurs or other abnormalities of the acromion.
Preparation
- Fasting for at least 8 hours before the procedure if general anesthesia is used.
- Adjustments to certain medications (e.g., blood thinners) as advised by the healthcare provider.
- Pre-operative imaging studies such as X-rays or MRI to assess the shoulder structure.
Procedure Description
- Anesthesia: The patient is given either general anesthesia or regional anesthesia with sedation.
- Incision: A small incision is made near the shoulder.
- Access: An arthroscope (a small camera) is inserted to provide visual guidance.
- Resection: Specialized surgical instruments are used to trim the lower surface of the acromion and remove any bone spurs; the coracoacromial ligament may also be released.
- Closure: The incisions are closed with sutures or staples, and a sterile dressing is applied.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Acromioplasty is usually performed in a hospital or outpatient surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurse
- Surgical Technician
Risks and Complications
- Infection
- Bleeding
- Shoulder stiffness
- Nerve injury
- Incomplete pain relief or recurrence of symptoms
- Reaction to anesthesia
Benefits
- Relief from shoulder pain
- Improved range of motion and shoulder function
- Enhanced quality of life Benefits are usually observed within a few months after surgery, with continual improvement as physical therapy progresses.
Recovery
- Immobilization with a sling for a few days to weeks.
- Pain management with prescribed medications.
- Physical therapy to restore shoulder strength and mobility.
- Full recovery typically takes 3 to 6 months, with follow-up appointments to monitor progress.
Alternatives
- Non-surgical treatments like physical therapy, anti-inflammatory medications, and corticosteroid injections.
- Other surgical options might include rotator cuff repair if a tear is present.
- Pros and cons of alternatives should be discussed with a healthcare provider to determine the best course of action.
Patient Experience
- During the procedure, the patient will be under anesthesia and will not feel pain.
- Post-procedure, there may be mild to moderate pain, which can be managed with medication.
- Swelling and bruising around the shoulder area are common.
- Gradual improvement in symptoms can be expected with adherence to rehabilitation protocols.