After anesthesia is applied, three incisions are made in the shoulder to gain access to the joint.
The surgeon then inserts a small metal tube into one of the incisions. The joint is expanded by pumping fluid into the joint through the tube. By expanding the joint this way, the surgeon is able to create space to see and perform the surgery.
A small camera called an arthroscope is then inserted through another incision. The arthroscope provides the surgeon with image guidance by transmitting pictures or video of the inside of the joint onto a television in the operating room. The surgeon uses the arthroscope to see the joint and determine what structures are causing the impingement.
Using the arthroscope, the surgeon removes the swollen bursa tissue using instruments inserted through the third incision.
If the coracoacromial ligament is also impinging on the rotator cuff, the surgeon inserts another tool through the third incision to remove it.
The portion of the acromion bone that was hooked is shaved away by the surgeon. This opens up the area above the supraspinatus tendon, taking pressure off the rotator cuff.
The fluid that was pumped into the joint at the beginning of the procedure is now drained. All instruments are removed, and the incisions are closed. Bandages are applied.