Acromioplasty (Subacromial Decompression)
Acromioplasty reshapes the underside of the acromion (the bony arch over the shoulder) to create more space for the rotator cuff tendons beneath it. Bone spurs and thickened bursa narrow this space over time and pinch the tendons with overhead movement. The procedure is arthroscopic, performed through small incisions, and frequently combined with rotator cuff repair or biceps tenodesis when those structures are also damaged.
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Who Needs Acromioplasty (Subacromial Decompression)?
Patients with shoulder impingement syndrome (pain with overhead activity, night pain, and weakness) that has not improved after 3-6 months of physical therapy and cortisone injection. Also commonly performed alongside rotator cuff repair when bone spurs contributed to the tendon tear and would continue irritating the repair.
What to Expect
Recovery Timeline
Arm in a sling for comfort. Ice and pain medication. Gentle pendulum exercises begin immediately.
Sling discontinued for isolated acromioplasty. Active-assisted range-of-motion. Driving resumes around 2-3 weeks.
Full active range-of-motion exercises. Progressive rotator cuff and scapular stabilizer strengthening.
Return to most daily activities and light recreational sports.
Full return to overhead sport and labor for most patients. Recovery extends significantly if rotator cuff repair was also performed.
Risks & Complications
- Persistent pain — more common if underlying rotator cuff damage was not addressed
- Stiffness requiring prolonged physical therapy
- Acromial fracture from excessive bone removal (rare)
- Infection (less than 1%)
Frequently Asked Questions
Does acromioplasty work?
The evidence is genuinely mixed for isolated impingement. Several randomized controlled trials show that for shoulder impingement without a rotator cuff tear, supervised physical therapy produces similar outcomes to surgery at one and two years. Surgery is appropriate only after conservative treatment has genuinely failed, not as a first resort. When done for the right patient with structural bone spurs and persistent symptoms, outcomes are good. When combined with rotator cuff repair, the rationale is more clear-cut.
How long is recovery after acromioplasty?
Recovery from isolated acromioplasty is fast by surgical standards. Most patients drop the sling within a week and return to desk work in 1-2 weeks. Light overhead activity resumes around 6-8 weeks. Athletes and overhead workers typically return to full activity by 3-4 months. When combined with rotator cuff repair, recovery follows the cuff timeline, which is significantly longer.
Will the bone spur come back?
Bone spurs typically do not regrow after proper arthroscopic removal. If shoulder pain returns years later, it is more commonly from new rotator cuff damage, progressive arthritis, or AC joint degeneration rather than spur recurrence. Continuing with the rotator cuff strengthening exercises learned in physical therapy is the best protection against future shoulder problems.
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$7,000 - $18,000 as an isolated procedure. Often bundled with rotator cuff repair, which substantially increases the total cost.
Full cost breakdownRelated Specialty
Shoulder Specialists →Related Conditions
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This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.