What is Shoulder Arthroscopy?

Shoulder arthroscopy is a kind of surgery that is done to explore or mend the tissues inside or surrounding the shoulder joint. The procedure makes use of a small camera, called an arthroscope, which is inserted through a small incision. Small surgical instruments are also used if the doctor is aimed at restoring the joint.

Effects of Shoulder Arthroscopy

Through arthroscopy, a patient can experience a reduced amount of pain and stiffness, less complications, shorter (if any) hospital stays, and perhaps more rapid recovery time.

Candidates for Shoulder Arthroscopy

Arthroscopy may be suggested for patients with shoulder problems such as a torn or damaged cartilage ring or ligaments (in cases of shoulder instability), a torn or damaged biceps tendon, a torn rotator cuff or a bone spur or inflammation around the rotator cuff. This procedure is also for those with stiffness of the shoulder, inflammation or damaged lining of the joint, and arthritis of the end of the clavicle (acromioclavicular joint).

Your Consultation

Non-operative management consists of a thorough history of the condition, details of the existing symptoms and disability, current and preceding medications and past medical history.

The Shoulder Arthroscopy Procedure

The procedure starts with the surgeon making a small incision, approximately one-quarter inch (0.25″) long, in the vicinity of the shoulder joint. Then a small camera is then inserted into the joint. Attached to the camera is a video monitor to allow the surgeon to look inside the joint. During the procedure, saline (salt solution) is pumped into the shoulder to enlarge the joint. By doing this, the surgeon will see the joint without difficulty and will be able to control bleeding, if any. Then the surgeon will look on all sides of the entire joint to evaluate the cartilage, tendons and ligaments of the shoulder. If damaged tissues show the need to be repaired, the surgeon will create one to three additional small incisions to insert other instruments. These instruments may contain a blunt hook to pull on tissues, a shaver to remove damaged or unwanted tissues, and a burr to remove bone.

Aside from working on the shoulder joint, the surgeon also locates the camera in the space on top of the rotator cuff tendons (this is named the subacromial space.) In so doing, the surgeon can evaluate the area above the rotator cuff, clean out inflamed or damaged tissue, eliminate a bone spur and fix a rotator cuff tear.

At the end of the surgery, the fluid is drained from the shoulder, the small incisions are closed, and a dressing is put on. Plenty of surgeons take pictures of the procedure from the video monitor to illustrate to the patient what was found and what was done.

Recovery

The recovery period depends on the type of surgery. One of the problems with shoulder arthroscopy is that the procedure has minimal pain compared to open shoulder surgery, and consequently, patients may be inclined to do too much, too soon. It is important that you listen to your surgeon about the limitations of your activities after surgery. Even though your shoulder may feel all right, it is imperative for to allocate enough time for repaired tissues to effectively heal. This is mainly significant for patients who have rotator cuff repairs and labral repairs.

The capacity for you to resume work or play sports will rely on the type of surgery that was carried out. This may vary from one week to several months. A majority of procedures, particularly if a repair was performed, would require physical therapy to assist rapid recovery. This will make it easier for you to recover the motion and strength of your shoulder. The duration of therapy will depend on the repair that was performed.

Risks

Anesthetic risks consist of allergic reactions to medications and problems breathing. On the other hand, the risks for any surgery are bleeding, infection and nerve damage. Further risks involve stiffness of the shoulder, failure of the surgery to alleviate symptoms, failure of the repair to mend and weakness of the shoulder.

FAQs

What happens during the procedure?

You will be given a general anesthetic and will be asleep for the entire operation. The surgeon will use an arthroscope that is connected to a television, and will insert it through one or two tiny half inch (about 1 cm) cuts in the region of your shoulder. The surgeon will then make use of it to look at the inside and the tendons over the shoulder. After that, the cuts will be closed with stitches, clips or paper tapes. You may have to stay in the hospital one night or so after the operation.

Is arthroscopic surgery better than “open” surgery?

It depends on the patient’s condition. Open surgery, a procedure which makes use of larger incisions and allows the surgeon to look inside the joint, may be better for specific procedures under specific conditions. Arthroscopic surgery may encompass a number of advantages–smaller incisions, less tissue damage–but these are typically not beneficial if the overall procedure cannot be achieved as well. You have to confer with your surgeon if a specific procedure can be done arthroscopically.

What should I expect after the surgery?

Arthroscopy is an option to “open” surgery that entirely exposes the shoulder joint. Arthroscopy results in reduced pain and stiffness, less complications, shorter (if any) hospital stays and probably quicker recovery time. The expectations differ depending on the goal of the surgery. In cases where repair is required, bear in mind that the body still needs to heal after arthroscopic surgery, similarly with an open surgery. As a result, the general recovery time may still be extensive. Surgery to repair a cartilage tear is commonly executed for the reason that the shoulder is not stable. A lot of patients have a complete recovery, and the symptoms of instability disappear. Nevertheless, up to 10 to 20% of patients can have sustained instability of the shoulder even after arthroscopic repair. Employing arthroscopy for rotator cuff repairs or tendonitis typically alleviates the pain, but the chance of determining how well your strength will return is minimal.

Are there complications in this procedure?

Rarely do complications occur following arthroscopy. The surgeon is not often capable of seeing everything he needs to see. At times, arthroscopy does not come up with any answers. Very rarely, there is bleeding inside the joint, or a certain infection that can be alleviated by taking antibiotics for a few days. It is also rare that more critical complications can come about like further damage to the joint or damage to the nerves or blood vessels in or around the area of the operation. In this case, you may well necessitate an additional operation to deal with the problem.