Shoulder arthroscopy is a surgical procedure used to visualize, diagnose, and treat various problems inside the shoulder joint and in the space surrounding the rotator cuff. This is done through small incisions that allow the insertion of specialized instruments. The arthroscope is a pencil-sized tool that contains magnifying lenses and a light source. This is attached to a small camera that projects a clear image of the joint on a TV monitor, allowing your surgeon to see all the structures inside your shoulder.
When Shoulder Arthroscopy Is Recommended
Your doctor may recommend shoulder arthroscopy if you have a painful condition that does not respond to nonsurgical treatment. Nonsurgical treatment includes rest, physical therapy, and medications or injections that can reduce inflammation. Inflammation is one of your body’s normal reactions to injury or disease. In an injured or diseased shoulder joint, inflammation causes swelling, pain, and stiffness.
Injury, overuse, and age-related wear and tear are responsible for most shoulder problems. Shoulder arthroscopy may relieve painful symptoms of many problems that damage the rotator cuff tendons, labrum, articular cartilage, and other soft tissues surrounding the joint.
Common arthroscopic procedures include:
- Rotator cuff repair
- Bone spur removal
- Removal or repair of the labrum
- Repair of ligaments
- Removal of inflamed tissue or loose cartilage
- Repair for recurrent shoulder dislocation
After surgery, you will stay in the recovery room for 1 to 2 hours before being sent to the day care ward. Nurses will monitor your responsiveness and provide pain medication, if needed.
Although recovery from arthroscopy is often faster than recovery from open surgery, it may still take weeks for your shoulder joint to completely recover.
You can expect some pain and discomfort for at least a week after surgery. If you have had a more extensive surgery, however, it may take several weeks before your pain subsides. Ice will help relieve pain and swelling. Your doctor may prescribe pain medicine, if needed.
Treating pain with medications can help you feel more comfortable, which will help your body heal faster and recover from surgery faster.
Opioids can provide excellent pain relief, however, they are a narcotic and can be addictive. It is important to use opioids only as directed by your doctor. You should stop taking these medications as soon as your pain starts to improve.
Although it does not affect how your shoulder heals, lying flat may pull on your shoulder and cause discomfort. Some patients are more comfortable sleeping in a reclining chair or propped up in bed during the first days after surgery.
A few days after surgery, you should be able to replace your large bandage with simple Band-Aids. You may shower once your wounds are no longer draining, but try not to soak or scrub your incisions. You will most likely need a sling or special immobilizer to protect your shoulder.
Rehabilitation plays an important role in getting you back to your daily activities. An exercise program will help you regain shoulder strength and motion. We shall develop a rehabilitation plan based on the surgical procedures you required.
It is important that you make a strong effort at rehabilitation in order for your surgery to succeed.
HOW IS SHOULDER ARTHROSCOPY PERFORMED?
Arthroscopy is typically performed in an outpatient surgery setting. The type of anesthesia used is up to the patient, surgeon, and anesthesiologist. Two or three small incisions, each the size of a dime, are needed to insert the scope and any necessary instruments. The joint is filled with sterile fluid to allow the surgeon to see more clearly. Most procedures take less than one hour to perform. Following surgery you may be in a sling or a special `shoulder immobilizer’ depending on the type of surgery performed. You will be given specific instructions about whether or not you are allowed to move your arm immediately after the surgery.
Rest, icing, and anti-inflammatory medications will help decrease pain and swelling. The surgical area should be kept dry when showering for the first 3-5 days. After this, simply change the dressings after bathing. Patients usually begin light exercise in 1 week.
Return to full activities may take several weeks to several months depending on the type of surgery performed.
BENEFITS OF ARTHROSCOPIC SHOULDER SURGERY
Benefits of arthroscopic surgery compared with older open surgical techniques include:
- Minimal scars
- No overnight hospital stay
- Decreased pain and swelling
- Improved motion
- Quicker functional recovery
- Fewer risks and complications