Name of the Procedure:

Coracoacromial Ligament Release, with or without Acromioplasty

Summary

The coracoacromial ligament release is a surgical procedure aimed at relieving shoulder impingement by releasing the coracoacromial ligament. Acromioplasty, often performed in conjunction, involves reshaping the acromion bone to create more space in the shoulder joint, thus reducing pain and improving mobility.

Purpose

This procedure addresses shoulder impingement syndrome, where the shoulder tendons are compressed or pinched during shoulder movements. The goal is to alleviate pain, restore shoulder function, and improve range of motion.

Indications

• Persistent shoulder pain not relieved by conservative treatments (e.g., rest, physical therapy, medications)
• Restricted shoulder movement affecting daily activities
• Confirmed shoulder impingement via imaging studies (e.g., X-rays, MRI)
• Pain associated with the coracoacromial arch

Preparation

• Fasting may be required several hours before the procedure.
• Patients may need to adjust or cease certain medications as advised by their doctor (e.g., blood thinners).
• Preoperative evaluations such as blood tests, physical exams, and imaging studies.

Procedure Description

1. The patient is placed under general anesthesia or regional anesthesia.
2. A small incision is made near the shoulder joint.
3. The coracoacromial ligament is carefully cut to relieve pressure on the tendons.
4. If performing acromioplasty, the surgeon reshapes or removes part of the acromion bone.
5. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

It is typically performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technologists

Risks and Complications

• Infection
• Bleeding
• Nerve injury
• Shoulder stiffness
• Incomplete relief of symptoms
• Anesthetic complications

Benefits

• Relief from shoulder pain
• Improved shoulder mobility
• Increased ability to perform daily activities
• The benefits are usually noticed within a few weeks to a few months post-surgery.

Recovery

• Patients may need to wear a sling initially to immobilize the shoulder.
• Pain management with prescribed medications.
• Physical therapy is often recommended to restore function and strength.
• Full recovery can take several weeks to a few months, with restrictions on heavy lifting and overhead activities.
• Follow-up appointments to monitor progress.

Alternatives

• Conservative treatments (physical therapy, medications, corticosteroid injections)
• Other surgical options such as rotator cuff repair or arthroscopic debridement
• Each alternative has its own set of pros and cons, which should be discussed with a healthcare provider.

Patient Experience

• During the procedure, the patient is under anesthesia and will not feel pain.
• Post-procedure, the patient may experience mild to moderate pain managed by medications.
• Some discomfort and swelling around the shoulder are normal and should subside within a few days.
• Adherence to post-operative care instructions and physical therapy will aid in a smoother recovery and better outcomes.