When is shoulder arthroscopy recommended?
Non-surgical treatments such as rest, physical therapy, medications, and injections are usually the first line of treatment for most hip conditions. However, your doctor might suggest hip arthroscopy if your condition does not respond to any of those treatments.
Shoulder arthroscopy can help to relieve painful symptoms of the problems causing damage to the rotator cuff tendons, labrum, articular cartilage and other soft tissues.
Common shoulder arthroscopy procedures include:
- Repairing rotator cuff tears
- Repairing labrum tears (e.g Bankart lesions) in shoulder instability
- Repairing superior labrum anterior-posterior (SLAP) tears, reattaching (tenodesis) or releasing (tenotomy) a torn long head of biceps tendon
- Removing bone spurs associated with subacromial impingement
- Releasing scar tissue in frozen shoulder
- Removing inflamed tissue or cartilage
- Treating painful acromioclavicular osteoarthritis
Surgical procedure
Positioning
- Your orthopaedic surgeon will either put you in a beach chair position where you are semi-seated like sitting in a reclining chair or a lateral decubitus position where you lie on your side on the operating table.
- The surgical team will then remove any hair if needed and apply an antiseptic solution over your shoulder. Your shoulder and arm will be covered with sterile drapes and your forearm will be placed in a holding device to maintain shoulder position.
Procedure
- Your orthopaedic surgeon will make small incisions, also known as portals, to insert the arthroscope into the shoulder. Sterile fluid is pumped into the shoulder to inflate the joint and ensure good visualisation
- Images from the arthroscope help your orthopaedic surgeon to evaluate the joint before proceeding with any specific treatments.
- Other small instruments will then be inserted through separate keyhole incisions to perform the surgery.
- Specialised instruments may be used for shaving, cutting, grasping, burring, inserting implants (suture anchors), suture passing and knot tying.
- Incisions will be stitched or covered up with skin tapes, followed by an absorbent dressing.
Shoulder Arthroscopy
Commonly Asked Questions
Planning for the Surgery
Your orthopaedic surgeon may recommend consulting your primary doctor or anaesthetist to assess your general health to identify any problems or health risks that may interfere with the surgery.
A shoulder arthroscopy can be performed as an outpatient treatment or require only an overnight hospital stay if you are generally healthy.
Consult your orthopaedic surgeon for specific instructions but you may have to stop taking traditional medicine, blood thinning medications and control your general medical conditions before the surgery.
Shoulder arthroscopy can be performed under regional block anaesthesia which will numb your arm and shoulder. However, most times, your orthopaedic surgeon will choose to combine it with general anaesthesia too as it can be uncomfortable to stay in one position for a long period of time during the surgery. Your orthopaedic surgeon and anaesthetist will discuss the best method with you.
A shoulder arthroscopy may take from less than an hour to about two hours depending on the severity of your condition and the complexity of the procedure.
Complications
Complications are uncommon but all surgeries carry a small risk of injury to the surrounding nerves, blood vessels or joints. There are also small risks of infection and shoulder stiffness.
Recovery
Feeling some pain is part and parcel of the healing process after surgery. Rest assured that your doctor will prescribe medications for short-term pain relief.
Paracetamol, non-steroidal anti-inflammatory drugs, and opioids are common temporary pain relief medications that will be prescribed.
You will likely need to wear a sling for comfort and to protect your shoulder repairs. You may feel more comfortable sleeping on a reclining chair or when propped up in bed. You should keep your dressings clean and dry to avoid the risk of infection. Your doctor will also provide you with a rehabilitation plan which includes specific exercises to help you restore strength and mobility.
