Rotator Cuff Surgery (side effects of SAD)

by F Gair
(Chico, CA)

I have a partial rotator cuff tear and my orthopedic surgeon has recommended surgery. I have viewed an online animation of the surgery, which shows removal of the bursa and the coracoacromial ligament, hollowing out of the acromium and installing an anchor with sutures, then suturing the torn area.

What I want to know is: what are the side effects of removing the bursa and the ligament? Don't we need these? Will my shoulder be weaker after surgery? Here is the animation of the video: surgery video

Thanks!

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Nov 03, 2008
great questions!
by: Bart - SII

These are great questions, and likely ones that many people have regarding the sub-acromial decompression (SAD). This is often part of a rotator cuff repair.

The subacromial bursa is not necessary for normal shoulder function. In fact, usually with impingement and rotator cuff tears, it is a large part of the problem because it becomes irritated and inflammed. It also loses some of its pliability and becomes fibrotic and stiff. This means that instead of acting like a cushion for the tendons, it actually increases the stress on the cuff.

The coracoacromial ligament does provide some stability, but it is not the only ligament that does this. The coracoclavicular ligament (shown in the video) also helps to stabilize the area, and provides enough stability that the CA ligament isn't necessary. Also, much like the bursa, with severe impingement and RC tears, the CA ligament often becomes irritated and inflammed and loses its normal ability to function, becoming stiff.

With good rehabilitation after surgery, you should have a good recovery, and since the tear is repaired and the subacromial space is larger, less likelihood of stress on the area.

Great Video Too!

Bart

Nov 11, 2008
Thanks!
by: FGair

Thanks so much for the clear explanation.

Jul 26, 2009
This really helped me!
by: Anonymous

Thank you for such a thoughtfully composed question and answer. I am about to undergo the surgery, and I googled "SAD" because I did not understand the hospital jargon. I am having severe anxiety, and this helped a lot. So, thanks!

Nov 29, 2011
surgery NEW
by: Anonymous

I had a fall in 2011 and I'm still having problems with my shoulder. I'm going in for another surgery on my shoulder next week. Your video really explains everything more clearly. Listening to my doctor explain what is going on is like someone talking a foreign language. I am going to question him about the bursa removal.

Nov 29, 2011
Update on shoulder NEW
by: Anonymous

I elected not to have the shoulder surgery and to do physical therapy instead. My shoulder has healed well and I have continued to work out with a personal training group. It is still not quite as strong as the other, but it is not painful and works well for my daily activities.

Mar 23, 2012
Been there, done that, got t-shirt NEW
by: Kim

I want to tell everyone out there that I had SAD surgery and full thickness tear repair on my left shoulder and then SAD surgery on my right shoulder 4 months later.
After suffering years of neck and arm pain an MRI highlighted severe damage in my left shoulder including a torn supra spinatus tendon and bone spurs. I had been suffering for over 8 years had steroid injections and my neck muscles had developed so well that they were lifting my arm up and not the muscles and tendons in my shoulder!! I can tell you that the pain is high and the recovery and rehabilitation is slow and over a very long time. You have to have a lot of patience and determination to get better. And you do get better. I have not looked back at all. I had the most courteous, polite and brilliant surgeon Mr Pimple from Darlington and Bishop Aukland hospitals in Co Durham. I owe him massive thanks to giving me my shoulders back and taking away all the pain.

If you are in doubt about getting the surgery, get a brilliant surgeon and a supportive family, do as you are told (walk before you can run)and go for it.
I actually got the opportunity to watch my surgery on my right shoulder. Gory and gruesome to some but fascinating to me.....

Sep 08, 2012
my shoulder pain NEW
by: louise

I have a history of shoulder pain (both shoulders)at present my latest spell of pain has been with me for over a year in my left shoulder and I am doing physio and ultra sonic wave treatment at my local hospital.My next orthopaedic appointment is this Monday-10th Sept and find it very hard to get over to the specialists that I can do all the movements that they are asking me to do at the appointments with moderate pain, the pain I cannot deal with is the pain I get when I do a movement and it is like something catches and that takes my breath away,it happens many times a day but I still do the movements and get through my working day and still have the strength in my shoulder.I have a high pain threshold and am determined to carry on my life with this pain but I get days when the pain has been particularly bad when I get emotional and depressed with it all
Does anyone else have similar symptons as mine?

Sep 28, 2012
Torn Rotar cuff NEW
by: Inez K.

This will be my 4th shoulder surgery and the pain will be no worse than it is now. I'm never without pain but I have a wonderfull Dr. He's from Houghston Sports Medicine Hospital in Columbus, Ga. and his name is John Waldrof. I drive 150 miles for surgery.
Therapy is a must and don't wait to start. I take a pain pill and cry with the pain. My Dr. see's that I have the best care after I get home. I'm 69 and my therapist is Pam and she helps my pain and tears.

Sep 28, 2012
Torn Rotar cuff NEW
by: Inez K.

This will be my 4th shoulder surgery and the pain will be no worse than it is now. I'm never without pain but I have a wonderfull Dr. He's from Houghston Sports Medicine Hospital in Columbus, Ga. and his name is John Waldrof. I drive 150 miles for surgery.
Therapy is a must and don't wait to start. I take a pain pill and cry with the pain. My Dr. see's that I have the best care after I get home. I'm 69 and my therapist is Pam and she helps my pain and tears.

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