Shoulder arthroscopy

Overview

Shoulder arthroscopy is a minimally invasive surgical procedure utilized both for the diagnosis and treatment of various shoulder issues. Conditions like rotator cuff tears or shoulder impingement may warrant this approach. Unlike traditional surgery, minimally invasive procedures involve smaller incisions, typically the size of a keyhole.

During the procedure, a small camera known as an arthroscope is introduced through a small incision in the skin. This arthroscope captures and projects images of the shoulder joint onto a video screen. The healthcare provider examines these images to identify the root cause of the injury. In cases requiring shoulder repair, miniature surgical instruments are employed to restore the shoulder’s functionality.

Types of procedure

Typical arthroscopy operations consist of:

• Rotator cuff repair (most common type of arthroscopy)
• Repair of ligaments
• Repair or removal of the labrum
• Removing the inflamed tissue or loose cartilage
• Repairing the recurrent shoulder dislocation

An arthroscope can also be used for uncommon treatments such cyst excision, fracture healing, and nerve release. Some medical treatments still call for open surgery and longer incisions, such as shoulder replacement.

Reasons for the procedure

A doctor may recommend shoulder arthroscopy for individuals experiencing a painful condition that has not improved with non-surgical treatments. Non-surgical treatments typically include methods such as rest, physical therapy, and medications or injections designed to reduce inflammation and facilitate the healing of injured tissues. Inflammation is a natural response by the body to injury or illness. When the shoulder joint is injured or affected by a disease, inflammation can lead to swelling, pain, and stiffness.

Most shoulder problems result from injury, excessive use, or age-related wear and tear. Shoulder arthroscopy has the potential to alleviate the painful symptoms associated with numerous issues that damage the rotator cuff tendons, labrum, articular cartilage, and other soft tissues that surround the joint.

Risk

Shoulder arthroscopy is generally considered a safe procedure, but there is a slight risk of experiencing:

• Blood clots.
• Damage to blood vessels or nerves.
• Excessive bleeding or swelling.
• Infection.

Procedure

Depending on the patient’s particular issue, a shoulder arthroscopy may be performed instead of open surgery (which requires a wider incision). Infection risk is lower, and the recovery period is shorter after arthroscopic surgery than after open surgery. Additionally, compared to open operations, shoulder arthroscopy typically results in reduced joint pain and stiffness.

Before the procedure

Before shoulder arthroscopy, your healthcare provider will review your medical history and require a complete medication list, with the possibility of discontinuing some medications prior to surgery. To assess your health prior to the procedure, additional evaluations may be necessary, such as blood tests, a chest X-ray, and an electrocardiogram.

During the procedure

Shoulder arthroscopy typically lasts less than an hour. During the procedure:

• You’ll be positioned semi-seated (in a beach chair position) or lying on your side.
• Your surgical team will clean your skin with antiseptic solution and may secure your arm in place.
• Fluid may be injected into your shoulder to expand the joint for better visibility.
• A small incision, roughly the size of a buttonhole, is made in your shoulder to insert a tiny camera (arthroscope).
• The camera displays images of your shoulder on a screen, helping the surgeon identify issues.
• Additional small incisions are made for inserting tiny instruments.
• After the surgery, the incisions are closed, often with stitches or small bandages, and a larger bandage is applied on top.

After the procedure

Shoulder arthroscopy is typically performed as an outpatient procedure, allowing you to return home on the same day, usually within an hour. Following the surgery, you’ll spend an hour or two in the hospital for recovery, during which pain medication may be provided if necessary. It’s important to arrange for someone, preferably a family member or friend, to accompany you and stay with you overnight to ensure a safe and supportive recovery process.

Outcome

After undergoing shoulder arthroscopy, the healing process for your shoulder joint typically spans several weeks to months. During this period, you may experience discomfort and swelling, which can persist for a few weeks. To alleviate pain, the use of ice and pain medication is recommended. Additionally, sleeping in an upright position, either in a chair or a bed, for a few days post-surgery can be beneficial. In some cases, your surgeon may advise the use of a sling to protect your shoulder.

After the surgical procedure, a rehabilitation plan becomes essential. This plan includes gentle exercises and physical therapy aimed at enhancing the range of motion and strength of your shoulder. Your healthcare provider will tailor this rehabilitation plan to align with the specifics of your shoulder surgery. The timeline for resuming your regular daily activities varies depending on the complexity of the surgery; individuals who undergo minor procedures may return to work or school within a few days, while those with more extensive surgeries will require a more extended recovery period. Your healthcare provider will provide guidance personalized to your specific recovery needs.

If any of the following symptoms are experienced after surgery, it’s important to consult with your healthcare provider:

• Fever
• Persistent pain unresponsive to medication
• Foul odor or unusual discoloration in the wound discharge
• Numbness or tingling sensations
• Increased swelling
• Excessive bleeding.