What is Shoulder Arthroscopy?

Shoulder arthroscopy is a medical procedure that utilizes a small camera, known as an arthroscope, to evaluate and repair injuries that affect the shoulder joint. As an alternative to open surgery, shoulder arthroscopy generally involves up to six months of post-operative recovery with limitations dependent on the extent of procedures employed during surgery. Performed to repair a variety of shoulder injuries, an arthroscopy procedure does carry significant risks and these should be discussed with a qualified health care provider prior to pursuing this treatment option.

Commonly known as shoulder surgery, shoulder arthroscopy may be employed to correct damage resulting from heavy lifting, repetitive movements, and falls. Individuals who have sustained torn ligaments, tendons, or tissue within the shoulder often require this corrective procedure to alleviate discomfort and restore proper functionality to the joint. Other conditions such as rotator cuff injuries, bone spurs, and joint inflammation may also be treated with shoulder arthroscopy.

Performed under general anesthesia, shoulder surgery initially involves a visual examination of the shoulder joint conducted with an arthroscope. A small incision is made in the shoulder and the tiny camera, which is connected to a monitor, is inserted to evaluate the tissues in and surrounding the joint. Once the assessment is completed, additional incisions may be made to accommodate instrumentation required to make necessary repairs. Upon completion of the procedure, stitches may be used to close the incisions over which sterilized bandages may be applied.

There are several procedures that may be conducted during a shoulder arthroscopy, depending on the type and extent of damage to the shoulder joint. The most common procedures performed involve correcting shoulder instability, rotator cuff repair, and correcting shoulder impingement syndrome. Depending on the condition of the shoulder joint more than one procedure may be necessary during surgery.

Shoulder instability generally requires repair to damaged ligaments and cartilage to restore stability and strength to the joint. Instability may also be due to the presence of either a Bankart or superior labrum anterior to posterior (SLAP) lesion, which involve tears to ligaments located in the lower or upper part of the shoulder joint respectively. Surgery to repair instability generally involves a tightening of the shoulder joint and the gathering of torn ligaments, which may be reinforced with the use of anchors and sutures. Any additional injury resulting from the presence of a lesion may be repaired during surgery.

Rotator cuff repair procedures require a repositioning and reinforcement of the damaged muscles and affected tendon. During surgery, the muscles of the joint are gathered and the tendon fastened to the bone with anchors and sutures. The anchors used during shoulder surgery are generally made of synthetic material, such as plastic or metal.

Impingement syndrome occurs when tissue becomes pinched in the shoulder joint. To alleviate painful symptoms and prevent further damage, the shoulder arthroscopy requires the removal of a small portion of the shoulder joint. Damaged surrounding tissue is excised and a minute part of the underside of the bone, known as the acromion, is removed. The surgery may also require the removal of part of the coracoacromial ligament to prevent further inflammation.

Preparations for surgery may begin two weeks prior to its scheduled date. Individuals may be advised to temporarily discontinue their use of any medications that may interfere with blood clotting. At least six hours prior to surgery, individuals may be instructed to not consume any food or drink.

Physical therapy may be necessary following surgery to rebuild motion and strength in the affected joint. Pain medication may be administered to help alleviate discomfort. Individuals may also be advised to wear a sling for the first few days following surgery. Recovery from shoulder arthroscopy may take up to six months and necessitate activity restriction for several more months.

Individuals who undergo shoulder surgery may experience complications following surgery that may include joint stiffness and shoulder weakness. Some may develop recurrent symptoms or sustain nerve damage. Additional risks associated with shoulder arthroscopy may include infection, blood clots and excessive bleeding. The use of general anesthesia carries risks of breathing difficulty and allergic reaction to medications administered.