SAD DCR Debridement
SAD DCR Debridement in San Antonio, TX
If your shoulder hurts when you reach overhead, sleep on the affected side or lift your arm away from your body, the cause may be crowding in the space under the top of your shoulder blade, arthritis at your AC joint, or both. When rest, therapy and injections have not been enough, arthroscopic cleanup may be considered.
Travis C. Burns, MD, a board-certified orthopedic surgeon in San Antonio, TX, evaluates shoulder pain at his Medical Center, Alamo Heights and Westover Hills offices. Dr. Burns specializes in arthroscopic surgery of the shoulder, and arthroscopic treatment of impingement syndrome and acromioclavicular arthritis is a focus of his practice. He aims to match the procedure to the cause of your symptoms.
What Is SAD DCR Debridement?
SAD DCR debridement is a combined arthroscopic procedure that includes subacromial decompression, distal clavicle resection and debridement of the labrum or rotator cuff, usually performed together in one operation. Subacromial decompression (SAD) removes inflamed tissue and, when needed, bone spurs under the acromion to create more room for your rotator cuff. Distal clavicle resection (DCR) trims a small portion of the end of your collarbone at the AC joint. Debridement cleans out inflamed or frayed tissue of the labrum or rotator cuff.
Related conditions are described on the Shoulder Impingement and AC Joint Injury pages. If your rotator cuff is torn, see Rotator Cuff Repair.
What Are the Benefits of SAD DCR Debridement?
If you are an appropriate candidate, this procedure may offer potential benefits:
- Pain relief: Creating more room and removing irritated tissue may ease pain with overhead use.
- Less pinching: Removing spurs may reduce rubbing on your rotator cuff.
- AC joint comfort: Trimming the end of the collarbone may reduce pain at the top of your shoulder.
- Minimally invasive approach: The procedure is performed arthroscopically through small incisions.
- Treating several problems at once: Related sources of pain may be addressed in one operation.
Your benefits depend on your condition and whether your pain is coming from the areas treated.
Who Needs SAD DCR Debridement?
You may be a candidate when your symptoms persist despite nonsurgical care. Situations may include:
- Pain with overhead reaching or lifting
- Night pain or pain lying on your shoulder
- Bone spurs or a tight space under the acromion on imaging
- Pain at the top of your shoulder with arthritis in the AC joint
- Tendon irritation or fraying that has not responded to therapy or injections
- Associated rotator cuff or labral problems that need treatment
Not every painful shoulder requires surgery. Many patients improve with rest, therapy, anti-inflammatory medication and injections, and Dr. Burns can discuss which approach fits you.
What Does Preparation for SAD DCR Debridement Involve?
Your evaluation includes an exam of shoulder strength and motion and imaging such as X-rays and MRI. Your surgeon may use an injection to learn which area is causing your pain, and a neck or nerve problem may also be considered.
Before surgery, you will receive instructions as outlined in the Preoperative Instructions.
How Is SAD DCR Debridement Performed?
The procedure is performed arthroscopically, as described on the Shoulder Arthroscopy page. A few small incisions are made, and a camera and instruments are used to inspect the joint and the space beneath the acromion.
Inflamed tissue is removed and, when needed, bone spurs under the acromion are smoothed. If your AC joint is painful, a small portion of the end of the collarbone is trimmed. Frayed labrum or rotator cuff tissue is cleaned out, and other problems are addressed as needed. The exact steps depend on what is causing your pain and are discussed with you before surgery.
The incisions are closed and a dressing and sling are applied.
What to Expect During Recovery After SAD DCR Debridement?
Dr. Burns' SAD DCR debridement protocol outlines each stage of your rehabilitation.
The First Week
You will use a sling for comfort only and typically stop wearing it within a few days. You can fully bend your shoulder, elbow, wrist and fingers right after surgery. Early exercises include hand squeezes, pendulums, shoulder shrugs and assisted motion in a pain-free range. Your sutures are typically removed 10 to 14 days after surgery. See the Postoperative Instructions.
Weeks 1 to 9
From weeks one to six, therapy works toward full active motion, with light band and weight exercises. From weeks six to nine, the goal is normal rotator cuff strength, with light bench press, overhead ball toss and a push-up progression. See the Physical Therapy Protocols page.
Returning to Activity
Between weeks nine and 12, you work toward a return to all activities, including regular push-ups, pull-ups, dips and swimming. Return to sports typically takes two to three months.
What Are the Risks and Complications of SAD DCR Debridement?
As with any surgery, there are potential risks. Possible risks and complications include:
- Infection
- Stiffness or loss of motion
- Bleeding or swelling
- Nerve or blood vessel injury
- Persistent pain or weakness
- Ongoing AC joint symptoms
- Shoulder instability after collarbone resection
- Complications related to anesthesia
Your surgeon can discuss these risks and how they apply to you based on your individual condition, health and activity goals.
Why Choose Dr. Burns for SAD DCR Debridement in San Antonio, TX?
Travis C. Burns, MD is a board-certified orthopedic surgeon with subspecialty fellowship training in orthopedic sports medicine through the John A. Feagin, Jr. Sports Medicine Fellowship. His practice centers on arthroscopic surgery of the shoulder, hip and knee, which makes careful diagnosis of shoulder pain central to his work.
Dr. Burns previously served as Chief of Sports Medicine at San Antonio Military Medical Center, where his clinical focus was complex shoulder, hip and knee injuries. He has been active in research and academic medicine, including more than 35 peer-reviewed publications. You can meet with him at the Medical Center, Alamo Heights or Westover Hills office, depending on what is most convenient for you.
SAD DCR Debridement FAQs
What is SAD DCR debridement?
SAD DCR debridement is a combined arthroscopic shoulder surgery that creates more room under the acromion, trims the end of the collarbone at the AC joint and cleans out frayed labrum or rotator cuff tissue.
What do SAD and DCR mean?
SAD means subacromial decompression, which creates room under the acromion. DCR means distal clavicle resection, which trims the end of the collarbone at the AC joint.
Is every part of the procedure done every time?
Not necessarily. The steps depend on what is causing your pain and what is found during surgery, and your surgeon can explain what is planned for you.
How long will I wear a sling?
Only a few days. The sling is for comfort, and you can move your shoulder right after surgery.
When can I return to sports?
Typically in two to three months, once you have full motion and normal rotator cuff strength.
SAD DCR Debridement in San Antonio, TX
If overhead pain or pain at the top of your shoulder is limiting you, an evaluation can help clarify the cause and your options. Request an appointment in San Antonio with Dr. Burns at the Medical Center, Alamo Heights or Westover Hills office to discuss your SAD DCR debridement options. You can call (210) 705-5060 to schedule a visit.
