What is shoulder arthroscopy?
Shoulder arthroscopy is surgery that uses a camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. It is often called “key hole” surgery. The arthroscope is inserted through a small incision (cut) in your skin. The arthroscopic camera allows fantastic vision around your shoulder joint, allowing a comprehensive assessment the structures and damage in your shoulder.
A number of procedures can be performed using the arthroscopic “key hole” technique.
- Acromioplasty and Decompression for shoulder bursitis and impingement
- Rotator cuff repair for torn rotator cuff tendons
- AC Joint Excision for painful AC joints
- Shoulder stabilisation for shoulder instability and dislocations
- Capsular Release for treatment of frozen shoulder
Who should have a shoulder arthroscopy?
Shoulder arthroscopy can be performed to treat these problems:
- Shoulder impingement syndrome | Bone Spur removal
- to make more room for the shoulder to move around by removing bone spurs and inflammed bursal tissue
- Rotator cuff tear
- these tears can be repaired using specialised “anchors” that reattach the torn tendon to the humerus.
- Shoulder stabilisation
- often known as shoulder reconstruction, the torn or damaged cartilage ring (labrum) or ligaments can be repaired and reconstructed.
- Biceps tenotomy or tenodesis
- A torn or damaged biceps tendon can either be cut away or repaired
- AC joint arthritis
- Arthritis of the end of the clavicle (collarbone) can be removed using key-hole surgery techniques
What happens during a shoulder arthroscopy?
The Anaesthetic
Most people receive general anesthesia before shoulder arthroscopy surgery. This means you will be asleep during the operation. Your arm and shoulder area may also be numbed so that you do not feel any pain in this area.
The Surgery
- The arthroscope is inserted into your shoulder through a small 1cm incision which is connected to a video monitor in the operating room.
- The tissues of your shoulder joint are inspected including the cartilage, bones, tendons, and ligaments.
- The damage tissue is repaired
- To do this, 1 to 3 more small incisions are made so that other instruments can be used to perform the operation.
At the end of the surgery your incisions will be closed with stitches and covered with a dressing.
Photos are taken during the procedure to show you what was found and what repairs were made.
Recovery and Rehabilitation
You will probably have to wear a sling for at least the first week. If you had a lot of rotator cuff repair or shoulder stabilisation done, you may have to wear the sling for 6 weeks.
Recovery can take anywhere from 1 to 6 months depending on what pathology was found during the arthroscopy and what repair was performed.
When you can return to work or play sports will depend on what your surgery involved. It can range from 1 week to several months.
For many procedures, especially if a rotator cuff repair is performed, physiotherapy may help you regain motion and strength in your shoulder. The length of treatment will depend on the repair that was done.
Complications
Complications are uncommon are shoulder arthroscopy, but like every surgical procedures, there are risks and complications involved.
The Risks for any anesthesia include:
- Allergic reactions to medicines
- Breathing problems
- Stroke and Cardiac problems
The risks for any surgery are:
- Bleeding
- Infection
- Blood clots and Deep Vein Thrombosis
Risks of shoulder arthroscopy are:
- Injury to a blood vessel or nerve
- Shoulder stiffness
- Failure of the surgery to relieve symptoms
- Failure of the repair to heal
- Weakness of the shoulder
Further Reading and References
- Clinical examination of the rotator cuff. PM R. 2013 Jan;5(1):45-56.
- Shoulder injuries – Management in general practice