Shoulder arthroscopy is a minimally invasive surgical procedure used to diagnose and treat a variety of shoulder problems. Unlike traditional open surgery, arthroscopy uses small incisions and specialized instruments, allowing quicker recovery, less pain, and reduced scarring. This article explains shoulder arthroscopy, how it works, the conditions it treats, and what to expect during and after the procedure.
What Is Shoulder Arthroscopy?
Shoulder arthroscopy is a surgical technique that uses a tiny camera called an arthroscope to visualize, diagnose, and treat issues within the shoulder joint. The arthroscope is inserted through a small incision in the skin, providing real-time images of the shoulder’s internal structures on a video monitor. The surgeon uses these images to guide miniature surgical instruments to repair or remove damaged tissues.
When Is Shoulder Arthroscopy Recommended?
Arthroscopy is often recommended when non-surgical treatments like physical therapy, medication, and injections fail to relieve shoulder pain or restore function. Common conditions treated with shoulder arthroscopy include:
1. Rotator Cuff Tears
Rotator cuff tears commonly cause shoulder pain resulting from injury or wear and tear. Arthroscopy allows the surgeon to repair torn rotator cuff tendons using tiny instruments to reattach them to the bone. This minimally invasive approach minimizes tissue damage and promotes faster healing.
2. Shoulder Impingement Syndrome
Shoulder impingement occurs when the shoulder bones compress the rotator cuff’s tendons. Arthroscopy can remove inflamed tissue and bone spurs, creating more space for the rotator cuff and reducing pain and inflammation.
3. Labral Tears
The labrum is a ring of cartilage that helps stabilize the shoulder joint. Tears in the labrum, often caused by injury or dislocation, can lead to pain and instability. Arthroscopic surgery can repair labral tears, restoring the shoulder’s stability and function.
4. Frozen Shoulder (Adhesive Capsulitis)
In severely frozen shoulders where conservative treatments fail, arthroscopy can release the tight and thickened joint capsule, allowing for an improved range of motion.
5. Shoulder Instability and Dislocations
Recurrent shoulder dislocations can damage the ligaments and labrum, leading to chronic instability. Arthroscopic surgery can tighten and repair these structures, reducing the risk of future dislocations.
6. Biceps Tendon Injuries
Injuries to the biceps tendon, such as tears or inflammation, can cause pain and weakness. Arthroscopy allows biceps tenodesis (reattaching the tendon to the humerus) to alleviate symptoms and restore shoulder strength.
How Shoulder Arthroscopy Works
1. Preparation for Surgery
Before the procedure, the patient undergoes a thorough evaluation, including a physical examination, medical history review, and imaging studies (X-rays, MRI) to assess the shoulder’s condition.
- Anesthesia: Shoulder arthroscopy is typically performed under general anesthesia, though regional anesthesia (nerve block) may also be used to numb the shoulder and arm.
2. The Procedure
- Incisions: The surgeon makes small incisions (portals) in the shoulder, each measuring about the size of a buttonhole.
- Insertion of Arthroscope: An arthroscope, a thin tube with a camera and light source, is inserted through one of the incisions. The camera transmits high-definition images to a video monitor, providing a clear view of the shoulder’s internal structures.
- Surgical Instruments: Small surgical instruments are inserted through the other incisions to repair or remove damaged tissues. Procedures may include trimming bone spurs, removing inflamed tissue, repairing torn tendons or ligaments, and smoothing rough cartilage.
- Flushing the Joint: During the procedure, the shoulder joint is often flushed with sterile fluid to improve visibility and remove debris.
3. Completion of Surgery
Once the necessary repairs are completed, the arthroscope and instruments are removed. The incisions are closed with sutures or small adhesive strips and covered with a sterile dressing.
What to Expect After Shoulder Arthroscopy
1. Immediate Postoperative Care
- Recovery Room: Patients are monitored in the recovery room as the anesthesia wears off. Most patients can go home the same day, although someone must be available to drive them home.
- Pain Management: Mild to moderate pain and swelling are common after arthroscopy. Pain can be managed with prescribed medications, ice packs, and rest.
- Sling: A sling may be provided to immobilize the shoulder and promote healing during the initial recovery period.
2. Rehabilitation and Recovery
- Physical Therapy: Physical therapy is crucial for restoring shoulder strength, flexibility, and range of motion. Therapy usually begins with gentle, passive movements and progresses to active exercises over several weeks.
- Activity Restrictions: Patients should avoid heavy lifting, overhead activities, and strenuous shoulder movements until cleared by the surgeon.
- Full Recovery: The recovery timeline varies depending on the procedure and the patient’s health. Most patients regain full shoulder function within 3 to 6 months.
Benefits of Shoulder Arthroscopy
- Minimally Invasive: Smaller incisions result in less tissue damage, reduced pain, and minimal scarring.
- Shorter Recovery Time: Compared to open surgery, arthroscopy typically involves a faster recovery period, allowing patients to return to normal activities sooner.
- Lower Risk of Complications: The minimally invasive nature of arthroscopy reduces the risk of infection and postoperative complications.
Risks and Complications
While shoulder arthroscopy is generally safe, potential risks include:
- Infection
- Bleeding
- Nerve or blood vessel damage
- Stiffness or loss of motion in the shoulder
- Failure to relieve symptoms or recurrence of the problem
Conclusion
Shoulder arthroscopy is a highly effective and minimally invasive surgical option for diagnosing and treating various shoulder conditions. With a shorter recovery time and lower risk of complications than open surgery, arthroscopy has become a preferred method for addressing shoulder pain and injuries. If you experience persistent shoulder issues, consult an orthopedic specialist to determine if shoulder arthroscopy suits you.
