Shoulder arthroscopy has been performed since the 1970s. It has made diagnosis, treatment, and recovery from surgery 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: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Your doctor may recommend shoulder arthroscopy if you have a painful condition that does not respond to nonsurgical treatment. Injury, overuse, and age-related wear and tear are responsible for most shoulder problems. Shoulder arthroscopy may relieve painful symptoms of many problems that damage the rotator cuff tendons, labrum, articular cartilage, and other soft tissues surrounding the joint.
Your surgeon will first inject fluid into the shoulder to inflate the joint. This makes it easier to see all the structures of your shoulder through the arthroscope. Then your surgeon will make a small puncture in your shoulder (about the size of a buttonhole) for the arthroscope. Fluid flows through the arthroscope to keep the view clear and control any bleeding. Images from the arthroscope are projected on the video screen showing your surgeon the inside of your shoulder and any damage.
After surgery, you will stay in the recovery room for 1 to 2 hours before being discharged home. Nurses will monitor your responsiveness and provide pain medication, if needed.
Many types of pain medication are available to help control pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and local anesthetics. Treating pain with medications can help you feel more comfortable, which will help your body heal faster and recover from surgery faster. A few days after surgery, you should be able to replace your large bandage with simple Band-Aids. You may shower once your wounds are no longer draining, but try not to soak or scrub your incisions
Rehabilitation plays an important role in getting you back to your daily activities. An exercise program will help you regain shoulder strength and motion. Your surgeon will develop a rehabilitation plan based on the surgical procedures you required.
If you have had a more complicated surgical repair, your surgeon may recommend a physical therapist to supervise your exercise program. It is important that you make a strong effort at rehabilitation in order for your surgery to succeed.
Rotator Cuff Repair - The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in its joint and help the shoulder joint to move. The tendons can be torn from overuse or injury.
Three common techniques are used to repair a rotator cuff tear:
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Bankart's Repair - The operation involves reattachment and tightening of the torn labrum and ligaments of the shoulder. This usually done using sutures and small bone anchors.
The glenoid labrum and the ligaments can be torn when the arm is forced backwards, allowing the humeral head to dislocate from the glenoid. If the labrum and the ligaments do not heal, the shoulder may continue to be unstable, allowing the ball to slip from the center of the glenoid even with minimal force.
When recurrent shoulder dislocations or feeling of instability interfere with the comfort and security of the shoulder, a repair of the ligaments and labrum by an experienced shoulder surgeon can usually restore the stability of the joint.
Surgical options : For traumatic anterior shoulder instability, the most dependable results have been obtained with an open (not arthroscopic) repair that securely restores the attachment of the labrum and the ligaments to the edge of the glenoid socket.
For shoulders in which the bone of the anterior (front) lip of the glenoid socket is lacking bone, grafting can be used to restore the configuration of the socket.
Subacromial Decompression - The operation aims to increase the size of the subacromial area and reduce the pressure on the muscle. It involves cutting the ligament and shaving away the bone spur on the acromion bone. This allows the muscle to heal.
Treatment Options : Before beginning treatment for shoulder pain, your doctor may take an X-ray. You doctor will also take a thorough history and examine you to ensure that the pain is not due to a problem in another area of the body.