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Shoulder Arthroscopy Surgery
Shoulder Arthroscopy Surgery – Shoulder arthroscopy is a procedure that allows an orthopedic surgeon to see and operate inside a joint using a device called an arthroscope. The arthroscope is inserted into the joint through a tiny incision in the skin. Arthroscopy is both a diagnostic and surgical procedure.
An arthroscope is a pen-shaped instrument with a very small video camera attached to the end. Lenses inside the arthroscope transmit an image that is projected onto a television screen. The image can be magnified as much as 30 times, giving the orthopedic surgeon an exceptionally clear view of the inside of a joint. From this view, the surgeon can then operate inside the joint using small instruments inserted through separate tiny incisions.
Joint surgery has improved greatly since the arthroscope was introduced. The Shoulder Arthroscopy Surgery is less traumatic, healing is faster, scarring is reduced, and recovery is quicker. Only a few tiny scars remain to show that the surgery was ever done.
Shoulder Arthroscopy Surgery may be recommended for shoulder problems, such as:
• A torn or damaged cartilage ring (labrum) or ligaments (in cases of shoulder instability)
• A torn or damaged biceps tendon
• A torn rotator cuff
• A bone spur or inflammation around the rotator cuff
• Stiffness of the shoulder
• Inflammation or damaged lining of the joint
• Arthritis of the end of the clavicle (acromioclavicular joint)
The Shoulder Arthroscopy Surgery
After the chosen anesthetic has been administered, the shoulder is thoroughly cleaned, usually with an iodine solution.
• Two to three tiny incisions, called portals, are made around the shoulder joint, in the back, front, and side of the shoulder.
• The surgeon usually inserts the arthroscope through a portal at the back of the shoulder (just below the outer bony prominence at the back of the shoulder).
• Specialized surgical instruments are inserted through the portal in the front of the shoulder.
• Instruments are frequently switched from portal to portal throughout the procedure.
If you are having an acromioplasty for a rotator cuff injury or impingement syndrome, the surgeon will also create a portal at the side of the shoulder to insert additional surgical instruments.
• In some cases, the surgeon will also make a fourth portal at the top of the shoulder.
The arthroscope projects magnified images of the inside of the shoulder onto a television screen. Sterile saline solution is run into the joint through one of the portals. It is necessary to have this fluid in the joint in order to see with the arthroscope. Specialized instruments are inserted into the joint through the portals, and the appropriate procedure is performed.
In the case of acromioplasty, the surgeon shaves a small portion of the bone from the underside of the acromion using highly specialized rotating or oscillating burrs. This gives the tendons of the rotator cuff or an irritated bursa more room to move and prevents these tissues from being pinched. If there is an accompanying bursitis, the inflamed bursal tissue may be removed as well.
Shoulder arthroscopy usually takes one to two hours. The length of the procedure will vary depending on the procedure and the extent of the damage within the shoulder.
Is an Open Surgery Better?
Sometimes the arthroscope will reveal damage that may be better repaired through and open surgical incision. In some cases, the open procedure can be done immediately. The possibility should be discussed with the doctor before the arthroscopy.
What To Expect After Shoulder Arthroscopy Surgery
In most cases, you will be able to return home on the day of the procedure. You will need a companion to drive you home, particularly if general anesthesia has been used. In some cases, an overnight hospital stay will be required.
• Incision care. The portal incisions are so small that they are not always closed with sutures. This will depend on the preference of the surgeon. Dressings are usually light and are kept on for a couple of days. Dressings and wounds should be kept clean and dry. Often, some drainage occurs from the wounds during the first day. This drainage is from the fluid used during the surgery. It is usually light and stops within the first 24 hours.
• Shoulder immobility. The amount of movement allowed following surgery will depend on the procedure that was done. Your doctor will give you very careful instructions about this. Following rotator cuff repair and repair of an unstable shoulder, certain shoulder movements are not allowed for a period of time. Your shoulder will be held in a sling, a sling and swath, or a brace following the surgery.
• Ice. Most doctors will recommend that ice be applied to the shoulder to control pain and swelling. Excessive swelling increases pain and may increase scarring, which in turn will tend to cause stiffness in the joint. You should apply ice for at least 20 minutes about three times a day. Ice should not be placed directly onto the skin. Place a moist towel on the skin and apply ice in a plastic bag directly over the towel.
• Medication will be prescribed for pain. This medication will usually be in the form of pills, but in some cases, when a one or two day hospital stay is required, a patient-controlled anesthesia (PCA) pump will be used. This pump provides pain medication at the push of a button that is connected to a dispensing machine. An intravenous catheter will be left in your arm to allow the medication to enter your bloodstream. PCA is usually continued for one or two days. The total amount of medication dispensed is carefully regulated so you cannot “overdose”.
Before you leave the hospital, you should have scheduled a visit to see the doctor within one to two days of the operation to assure that your wounds are healing properly and all is going well. A visit at approximately three to four weeks with your family physician will serve to assure progress in therapy. Follow up with your physical therapist is essential to assure adequate rehabilitation.
How Long Until Full Recovery of a Shoulder Arthroscopy Surgery?
The time it takes for a return to unlimited activities will depend on:
• The original problem
• The procedure that was performed
• The repair that was made
• The individual patient
Usually, at least six weeks of recovery time are required. In general, activities will be limited and gradually increased until the range-of-motion and strength in the repaired shoulder is equal to that of the other arm.
Repair of a rotator cuff tendon or shoulder dislocation usually takes four to six months to heal well enough for a return to full activity.
When Can I Return to Work?
In some cases, you may be able to return to light work within a few days. Depending on the procedure, heavy labor or contact sports may be limited for about six months, though you will be allowed a lighter type of work. But during this period, you will be continuing the exercise program set by the therapist and your doctor as you continue to strengthen the shoulder.
To hear about the experiences of MedToGo International clients who have undergone Shoulder Arthroscopy Surgery, please visit our testimonials page.