Shoulder Arthroscopy

Dr. Rahul Damle – Shoulder Arthroscopy Specialist

Overview & Description

The surgeon makes a small incision, about one-quarter inch (0.25″) long, near the shoulder joint. A small camera is then inserted into the joint. The camera is attached to a video monitor to allow the surgeon to see inside the joint.

Unlike knee arthroscopy, most patients are asleep during the surgery. Therefore, you will be unable to watch the video monitor. A nerve block may be used to numb the shoulder and arm to help reduce pain after surgery.

Saline (salt solution) is pumped into the shoulder to expand the joint. This helps the surgeon see the joint and helps control any bleeding.

The surgeon will look around the entire joint to evaluate the cartilage, tendons, and ligaments of the shoulder. If damaged tissues need to be repaired, the surgeon will make one to three additional small incisions to insert other instruments.

At the completion of the surgery, the fluid is drained from the shoulder, the small incisions are closed, and a dressing is applied. Most surgeons take pictures of the procedure from the video monitor to show the patient what was found and what was done.

 

Indications

Arthroscopy may be recommended for shoulder problems, such as:
1. A torn or damaged cartilage ring (labrum) or ligaments (in cases of shoulder
instability)
2. A torn or damaged biceps tendon
3. A torn rotator cuff
4. A bone spur or inflammation around the rotator cuff
5. Stiffness of the shoulder
6. Inflammation or damaged lining of the joint
7. Arthritis of the end of the clavicle (acromioclavicular joint)

Preparing for Surgery

During your pre-op visit, lab tests will be advised to insure that you are in good general health. Chest x-rays and an ECG are obtained if you have not had one taken for six months or if otherwise indicated. A physician will also review your medical history and the medications that you take. He will do a general physical exam.

Expectations after Surgery

Arthroscopy is an alternative to “open” surgery that completely exposes the shoulder joint. Arthroscopy results in less pain and stiffness, fewer complications, shorter hospital stays, and possibly faster recovery time.
The expectations vary depending on the purpose of the surgery. In cases where repair is needed, remember that the body still needs to heal after arthroscopic surgery, just as if the surgery was done openly. Therefore, the overall recovery time may not change.
Surgery to fix a cartilage tear is usually performed because the shoulder is not stable. Many patients have a full recovery, and the symptoms of instability go away.
Using arthroscopy for rotator cuff repairs or tendonitis usually relieves the pain.

Convalescence & Recovery

The patient is usually discharged from the hospital within 1-2 days depending upon the condition the patient was operated for.
Recovery can take anywhere from one to six months, depending on the surgery that was performed. Most patients wear a sling for the first few weeks. If a more extensive repair was performed, the sling may be worn longer. Pain medications are often used.
The ability for you to return to work or play sports will depend on the surgery that was performed, ranging from one week to several months.
For many procedures, especially if a repair is performed, patient specific physical therapy will be needed. This will help you regain the motion and strength of your shoulder. The length of therapy will depend on the repair that was performed.

What are the possible complications?


Although uncommon, complications do occur occasionally during or following arthroscopy. Infection, phlebitis (blood clots of a vein), excessive swelling or bleeding, damage to blood vessels or nerves, and instrument breakage are the few complications that can occur but do so in less than 1 percent of all arthroscopic procedures.

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