Challenging cases of chronic shoulder bursitis, tendinitis, and resulting shoulder impingement syndrome may warrant surgery. Below are descriptions of the surgeries most often performed. The type of surgery recommended depends on symptoms and the underlying cause of the pain.
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Bursectomy. In a traditional bursectomy an incision is made at the shoulder and the troublesome bursa is removed. Some doctors perform arthroscopic bursectomies, which are thought to lower the risk of complications and shorten the healing period. After a bursa is removed, a new bursa may form in its place. A newly formed bursa is typically less prone to irritation and causing painful symptoms.
Tendon and muscle repair. When shoulder bursitis or impingement is caused by damage to a rotator cuff muscle or tendon, a surgical correction may be made. For example, a torn tendon may be repaired and reattached to the humeral head.
Subacromial decompression (acromioplasty). During subacromial decompression surgery part of the acromion is removed. The goal is to create more space for the shoulder’s soft tissue and reduce painful symptoms. Subacromial decompression is often done along with a bursectomy, however, recent research questions whether this surgery is any more effective than a bursectomy alone, which is less invasive and easier to recover from.10
It is possible that more than one procedure will be performed during the same surgery. For example, a surgeon may perform both a bursectomy and tendon repair in an effort to relieve a patient’s symptoms. After surgery, the patient may be asked to wear a sling for a set period of time and participate in physical therapy.
- Donigan JA, Wolf BR. Arthroscopic subacromial decompression: acromioplasty versus bursectomy alone--does it really matter? A systematic review. Iowa Orthop J. 2011;31:121-6. PubMed PMID: 22096430; PubMed Central PMCID: PMC3215124.