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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Rotator Cuff Surgery (side effects of SAD)

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Nov 03, 2008
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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
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Thanks!
by: FGair

Thanks so much for the clear explanation.

Jul 26, 2009
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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!