Rotator Cuff Tears: Bone Spur Removal (Subacromial Decompression)

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Impingement syndrome and associated rotator cuff tears are commonly encountered shoulder problems. This condition is caused when the rotator cuff tendons rub on a bone spur on the unnderside of the acromion bone. Chronic rubbing can lead to a weakening and even tearing of the rotator cuff.

Rotator Cuff Pain

The underside of the acromion bone rubs the rotator cuff tendons causing pain and weakness. More space will be created for the rotator cuff by removing part of the acromion.


Small incisions (portals) are made around the joint. The scope and surgical instruments will go into these incisions.


The scope is inserted into the back of the shoulder joint. Saline solution flows through a tube (cannula) and into the bursa sac to expand the joint and to improve visualization. The image is sent to a video monitor where the surgeon can see inside the joint.

Bursa Sac and Coracoacromial Ligament Removal

A specialized surgical instrument is used to remove the inflamed and irritated bursa sac. This instrument is about the size of a pen and shaves away the inflamed tissue and removes tiny pieces through a suction attachment.

Removing Bone

A similar instrument is then used to remove bone from the underside of the acromion. More space is created for the rotator cuff tendons. The acromion is flattened so that the bone no longer rubs on the rotator cuff.

End of Procedure

After more space has been created between the acromion and the rotator cuff, the surgical instruments are removed and the procedure is completed.