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Shoulder Arthroscopy

Shoulder Arthroscopy

Arthroscopy is a procedure in which the orthopaedic surgeon inspect, diagnose, and treat problems inside a joint.

The word arthroscopy comes from two Greek words, "arthro" (joint) and "skopein" (to look). The term literally means "to look within the joint." During shoulder arthroscopy, your surgeon inserts a small camera which is called an arthroscope, into your shoulder joint. The camera displays pictures on a video monitor, and the surgeon uses these images to guide miniature surgical instruments and repair torn tissues within the joint.. Shoulder arthroscopy has been performed since the 1970s. It has made diagnosis, treatment, and recovery more easier and faster than was once thought possible. Improvements to shoulder arthroscopy occur every year as new instruments and techniques are developed.

Anatomy

Your shoulder is a complex joint that is capable of more motion than any other joint in your body. It is made up of three bones: the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle).

  • Ball and socket: The head of your upper arm bone fits into a rounded socket in your shoulder blade. A slippery tissue called articular cartilage covers the surface of the ball and the socket. It creates a smooth, frictionless surface that helps the bones glide easily across each other.
  • Shoulder capsule: The joint is surrounded by bands of tissue called Ligaments. They form a capsule that holds the joint together. The undersurface of the capsule is lined by a thin membrane called the Synovium. It produces synovial fluid that lubricates the shoulder joint.
  • Rotator Cuff: Four tendons surround the shoulder capsule and help keep your arm bone centered in your shoulder socket. This thick tendon material is called the rotator cuff. The cuff covers the head of the humerus and attaches it to your shoulder blade.
  • Bursa: There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa helps the rotator cuff tendons glide smoothly when you move your arm.

Injuries that can be treated by an arthroscopic shoulder surgery

Shoulder arthroscopy can remove an inflamed tissue.
It can be used to treat:

  • Bicep Tendon Injuries
  • Bone Spurs
  • Frozen Shoulder
  • Recurrent Shoulder Dislocation
  • Osteoarthritis
  • Rotator Cuff Tears
  • Shoulder Impingement Syndrome
  • If the shoulder joint has become loose or dislocated

As with any injury, the doctor will be the best source of advice on the appropriate treatment method for your current situation.

How is shoulder arthroscopy performed?

Arthroscopy is performed in an inpatient surgery setting.Two or three small incisions, each the size of 4mm-6mm are needed to insert the scope and any necessary instruments. The joint is filled with sterile fluid to allow the surgeon to see more clearly. Most procedures take less than one hour to perform. Following surgery you may be in a sling or a special shoulder immobilizer' depending on the type of surgery performed. You will be given specific instructions about whether or not you are allowed to move your arm immediately after the surgery.

Rest, icing, and anti-inflammatory medications will help decrease pain and swelling. The surgical area should be kept dry when showering for the first 3-5 days. The modern dressing is waterproof & allows direct showering over the dressing. 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.

What happens before Shoulder Arthroscopy?

Before shoulder arthroscopy, your doctor will ask about your medical history. You must tell them about all the medication. The hospital will give you specific instructions, including how long before surgery you should stop eating and drinking. To fully determine the state of your health, you may also need:

  • Blood Tests
  • Digital X-ray
  • ECG

What happens during a shoulder arthroscopy?

Shoulder arthroscopy usually takes less than an hour. During this time:

  • You are in a semi-sitting position (recliner).
  • The hair is shaved by your surgical team (if necessary) and your skin is cleansed with an antiseptic solution. To ensure you remain still, your arm is placed in restraint.
  • Your surgeon will make a small hole in your shoulder, usually about the size of a buttonhole. A small camera (arthroscope) is inserted into this incision.
  • The camera projects images of your shoulder onto a video screen. Your surgeon will use these images to identify the problem.
  • Your surgeon will make tiny incisions in your shoulder and insert tiny instruments.
  • Once the surgical team has finished your surgery, they will close the incisions.

You may have stitches or small bandages with a large bandage over them.

How painful is shoulder arthroscopy?

Unlike open surgeries, all arthroscopic surgeries are less painful and also the staff at our hospital makes sure you are as comfortable as possible during the surgery. They will explain and confirm the options with you.

During the shoulder arthroscopy surgery, nerve blocks are often injected into the neck or shoulder. These nerve blocks cause numbness in the shoulder and arm.

They also help in post-surgery pain relief. In most cases, you will be given general anesthesia to sleep during the surgery.

Benefits of arthroscopic shoulder surgery

Depending on your condition, a shoulder arthroscopy may be performed instead of open surgery (with a wider incision). Arthroscopy has a lower risk of infection and a quicker recovery time than an open surgery.

Shoulder arthroscopy is also less painful and causes less joint stiffness than an open surgery.

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

  • Minimal Scars
  • Minimal Hospital Stay
  • Minimal Pain and Swelling
  • Minimal Stiffness
  • Minimal Risks and Complications

What to do at home after a shoulder arthroscopy?

Wound Care

  • Wounds should be kept dry for 1 week.
  • The wound should not get wet within three weeks of the surgery, so avoid doing anything that may cause that.
  • Once the bandage is removed on the 7th day, ice is applied for 20 minutes, three to four times a day.

Exercise and Mobility

First day after surgery, start with the physiotherapy exercises given

  • You may use your arm to dress, eat, and clean yourself unless specifically instructed by your doctor.
  • Be sure to use and move your hand, wrist, and elbow to reduce swelling in your arm. While exercise is important, do not do more than required.

Sleep and Shoulder Support

  • Patients generally sleep more comfortably in a recliner or with pillows behind the operated shoulder.
  • After surgery, wearing a sling for three weeks is common. In some cases, the doctor may ask you to wear the sling longer.

When should I see my doctor?

Talk to the doctor if you have any of the following these symptoms after your surgery:

  • High Fever
  • Pain Persists Despite Medications
  • Discolored or Foul-smelling fluid around the wound
  • Tingling or Numbness
  • Increased inflammation

To know more kindly contact the best orthopaedic surgeon Dr. Rahul Modi for further queries.
This surgery is frequently performed by the best orthopaedic surgeon Dr. Rahul Modi for treating Shoulder Arthroscopy.