Open Acromioplasty Corrects shoulder impingement syndrome1.pptx

Open Acromioplasty

1. Acromioplasty Open Acromioplasty (Student’s Name)

2. Introduction Shoulder impingement T endons of the rotator cuff muscles become compressed between the shoulder blade and the head of the humerus Symptoms: Pain with overhead activities Pain at rest, especially at night Weakness in the affected shoulder

3. Acromioplasty Acromioplasty Corrects shoulder impingement syndrome A imed at: relieving pain improving function It involves reshaping the acromion ( Lavignac et al., 2021)

4. Anatomy Anatomy of the Shoulder Complex: Glenohumeral joint Acromioclavicular joint Coracoclavicular ligament Subacromial space Structures involved in shoulder impingement syndrome: Acromion Subacromial bursa Rotator cuff tendons ( Supraspinatus, Infraspinatus, Teres minor, Subscapularis ) ( Jdcadmin , 2020)

5. Shoulder Mechanics Normal Shoulder Mechanics : Articulation of the shoulder complex Flexion , extension, abduction, adduction, internal and external rotation R otator cuff muscles-stabilize the shoulder joint Mechanism of Shoulder Impingement: Narrowing of subacromial space Compression of structures (bursa, tendons) Space between the acromion and humeral head narrows, leading to impingement I nflammation and pain ( Goetti et al., 2020)

6. Diagnostic Interventions Clinical Assessment: History taking Physical examination Functional tests- Neer Hawkins-Kennedy ( Lavignac et al., 2021) Imaging Studies : to evaluate bony and soft tissue structures X-ray MRI Ultrasound

7. Interventions Indications for Open Acromioplasty : Persistent shoulder pain Failed conservative treatment Shoulder impingement syndrome Goals: Decompression of subacromial space Relief of impingement symptoms Restoration of shoulder function Arthroscopic shoulder acromioplasty . Doctor Matthieu Meyer. (2021, January 13).

8. Procedural Steps Patient positioning: beach chair or lateral decubitus . Draping: including the shoulder, upper arm, and surrounding areas; fenestration centered over the shoulder Skin prep: chlorhexidine gluconate or povidone-iodine Anesthesia: general anesthesia or regional block . Incision : typically a small deltoid-splitting incision and identification of structures (acromion, bursa, rotator cuff) Acromion exposure: careful dissection to expose the acromion and rotator cuff. Acromioplasty : removal of the anterior undersurface of the acromion using burrs or shavers. Closure: layered closure of soft tissues .

9. Counts, Catheters/Drains, Dressings Counts pre- and post-surgery: Sponge , instrument, and sharps counts Catheters/Drains : May be placed to prevent hematoma formation, usually removed within 24-48 hours. Dressings: Sterile , non-adherent dressings applied over the incision site . Specimen : Removed bone fragments may be sent for histological examination if necessary.

10. Complications and Wound Management Special Considerations Careful preservation of deltoid muscle fibers to minimize postoperative weakness Complications : Infection Neurovascular injury Recurrent impingement Recurrent impingement ( Varshneya et al., 2020) Wound Management: Monitor for signs of infection Suture removal timeline Rehabilitation protocol initiation

11. Additional Information Equipment and Supplies: Surgical drapes Sutures (absorbable/non-absorbable) Hemostatic agents Sterile gloves/gowns Instruments: Scalpel Retractors Rongeurs Burrs Arthroscopic shavers (if arthroscopy-assisted )

12. References Arthroscopic shoulder acromioplasty . Doctor Matthieu Meyer. (2021, January 13). https://www.dr-meyer-orthopaedics.com/operations/shoulder/painful-shoulder/shoulder-acromioplasty/ Goetti , P., Denard , P. J., Collin, P., Ibrahim, M., Hoffmeyer , P., & Lädermann , A. (2020). Shoulder biomechanics in normal and selected pathological conditions.  EFORT open reviews ,  5 (8), 508-518. Jdcadmin . (2020). Basic shoulder anatomy. Retrieved from https://shoulderpaininfo.com/basic-shoulder-anatomy/ Lavignac , P., Lacroix , P. M., & Billaud , A. (2021). Quantification of acromioplasty . Systematic review of the literature.  Orthopaedics & Traumatology: Surgery & Research ,  107 (4), 102900 . Varshneya , K., Safran , M. R., Sherman, S. L., & Abrams, G. D. (2020). Costs, complications, and reoperations associated with primary arthroscopic rotator cuff repair with or without acromioplasty and/or biceps tenodesis .  Arthroscopy, Sports Medicine, and Rehabilitation ,  2 (4), e369-e376.

13. Thank You!