Arthroscopy of the Shoulder Treatment

What is Arthroscopy of the Shoulder?

Shoulder arthroscopy is a surgical process used for visualizing, diagnosing, and treating different problems inside the shoulder joint and in the space surrounding the rotator cuff. This procedure is performed with the help of small cuts that allow the insertion of specialized instruments. An arthroscope is a pencil-sized tool that carries a light source and magnifying lenses. The arthroscope is attached to a small camera that projects a clear image of the joint on a TV monitor, which allows the surgeon to see all the structures inside the patient’s shoulder

When Shoulder Arthroscopy Is Recommended?

The doctor may suggest shoulder arthroscopy if the patients have a painful condition that does not respond to the nonsurgical treatment. Nonsurgical treatment includes physical therapy, rest, and medications or injections that reduce inflammation, swelling, pain, and stiffness.

Injury, overuse, and age-related wear and tear are the main reasons for most of the shoulder problems. Shoulder arthroscopy may be helpful in relieving the painful symptoms of many problems that damage the labrum, rotator cuff, tendons, articular cartilage, and other soft tissues that surround 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

Benefits of Arthroscopic Shoulder Surgery

Benefits of arthroscopic surgery as compared with older open surgical techniques include the following:

• Minimal scars
• No overnight hospital stay
• Decreased pain and swelling
• Improved motion
• Quicker functional recovery
• Fewer risks and complications

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 that allows the surgeon to view more clearly. Most of the procedures take less than one hour to complete. Following surgery, the patients may be in a sling or a special shoulder immobilizer depends on the type of surgery being done. The patients will be given particular instructions about whether or not they are allowed to move their arm immediately after the surgery or not. Rest, icing, and anti-inflammatory medications will help decrease pain and swelling. The surgical area should be kept dry when the patients take a shower 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.

How soon will I recover?

At Home

Although recovery from arthroscopy is generally faster than recovery from the open surgery, it may still take weeks for the shoulder joint to completely recover.

The patients can experience some pain and discomfort for at least a week after surgery. If the patients have undergone more extensive surgery, however, it may require several weeks before the pain is reduced. Ice will help in relieving the pain and swelling. The doctor may suggest some pain medicine if required.

Rehabilitation

Rehabilitation plays a vital role in getting the patients back to their daily activities. An exercise program will help them regain their shoulder strength and motion. The surgeon will develop a rehabilitation plan based on the surgical process the patient needs. If the patients have had a more complicated surgical repair, the surgeon may advise a physical therapist to oversee their exercise program. It is vital that the patients make a strong effort at rehabilitation in order for their surgery to succeed.

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What are the risks involved?

Infection

Infection is a serious concern whenever undergoing surgery, whether a major surgical procedure or even a minor treatment. Bacteria are present on the skin and in the environment, and even with great caution, there is a chance of developing an infection anytime the patients have undergone surgery. Shoulder surgeries are more susceptible to develop common skin bacterial infections such as staph and strep (the most common types of surgical infections).

Nerve Injury

Nerve injury is very rare, but with the number of major nerves that surround the shoulder joint, this is a possible complication of surgery. When work is needed at the bottom of the shoulder (the inferior capsule or labrum) there is a certain concern of injury to the nerves. Nerves can either be injured by the instruments that are working inside the shoulder joint, or by inserting the instruments very close to the nerves that surround the shoulder joint.

Frozen Shoulder

One of the most common problems after shoulder surgery is being performed is the stiffness of the shoulder joint. For some surgical procedures, a period of time of immobilization is important for allowing adequate healing. However, immobilization of the joint can also result in the patients to develop a condition known as the frozen shoulder. Frozen shoulder is usually treated with the help of aggressive therapy and sometimes with the help of a cortisone injection. Many cases of frozen shoulder take a month or even longer to resolve.

Chondrolysis

Chondrolysis is a very rare but potentially serious complication of shoulder arthroscopy. Chondrolysis causes damage to the cartilage of the joint surface and can result in early progression of arthritis of the joint. This is very problematic for young patients who have developed this condition after the treatment of an athletic injury. Normally, the belief of these patients is to restore the full functioning of the shoulder, and chondrolysis can result in permanent problems with the shoulder joint if the cartilage is being damaged badly.

Head/Neck Injury                

One of the problems of shoulder surgery is the locations of the joint. Surgical drapes cover the head and neck area during the surgery for preventing contamination and infection, but this can restrict the ability to view the head and neck by the anesthesiologist. Surgeons must take great care for protecting and supporting the head and neck for ensuring there are no injuries due to poor patient positioning.

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