Shoulder arthroscopy is a type of surgery to examine or repair the tissues inside or around the shoulder joint. The procedure uses a small camera, called an arthroscope which is inserted through a small incision. If the surgeon plans to repair the joint, small surgical instruments are also used.
A small incision is made, about one-quarter inch (0.25") long, near the shoulder joint. and 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 have a general anaesthetic and therefore are 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 is pumped into the shoulder to expand the joint. which 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, one to three additional small incisions will be made to insert other instruments. These may include a blunt hook to pull on tissues, a shaver to remove damaged or unwanted tissues, and a burr to remove bone.
In addition to working on the shoulder joint, the surgeon often places the camera in the space above the rotator cuff tendons. (This is called the subacromial space.) The surgeon can evaluate the area above the rotator cuff, clean out inflamed or damaged tissue, remove a bone spur, and fix a rotator cuff tear.
Following surgery, the fluid is drained from the shoulder, the small incisions are closed and a dressing is applied.
Arthroscopy may be recommended for shoulder problems, such as:
- A torn or damaged cartilage ring (labrum) or ligaments (in cases of shoulder instability)
- A torn or damaged biceps tendon
- A torn rotator cuff
- A bone spur or inflammation around the rotator cuff
- Stiffness of the shoulder
- Inflammation or damaged lining of the joint
- Arthritis of the end of the clavicle (acromioclavicular joint)
Arthroscopy is an alternative to "open" surgery that completely exposes the shoulder joint. Arthroscopy results in less pain and stiffness, fewer complications, shorter (if any) 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 open surgery had been carried out. Therefore, the overall recovery time may still be lengthy.
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 are resolved. However, up to 10-20% of patients can have continued instability of the shoulder even after arthroscopic repair.
Recovery can take anywhere from one to six months, depending on the surgery performed. Most patients wear a sling for the first week. If a more extensive repair has been performed, the sling may be worn longer. Pain control medications are often used.
Returning to work or playing sports will depend on the surgery performed, ranging from one week to several months