What is shoulder arthroscopy?
Shoulder arthroscopy is a minimally invasive surgical technique used to evaluate and treat a variety of conditions affecting the shoulder. This technique involves 2 – 4 small (1-2 cm) incisions. Fluid is pumped into the shoulder to distend space within the shoulder joint. A small camera (known as an arthroscope) is inserted into the shoulder via one of the incisions. Small instruments, such as a probe, scissors, or shavers, are inserted into the other incision(s) to perform the surgery.
What conditions can be treated by a shoulder arthroscopy?
Shoulder arthroscopy is commonly used to evaluate and treat rotator cuff tears, labral tears, disorders of the biceps tendon, and impingement syndrome and bursitis. It can also be used to treat lesions involving the articular cartilage. In addition shoulder arthroscopy can be used for diagnostic purposes in patients who fail to respond to non-surgical treatments.
What can you expect when undergoing shoulder arthroscopy?
Although shoulder arthroscopy is a very common and safe procedure, it is still a surgical procedure which requires general anesthesia. As a result your surgeon will typically require that pre-operative blood work be obtained prior to undergoing surgery. In addition for patients over the age of 40 or with history of medical problems, often medical clearance obtained from your primary care physician will be required. Once blood work and/or medical clearance has been obtained then the surgery is scheduled.
Prior to surgery patients taking any anti-inflammatory medications (such as Advil, ibuprofen, or Naprosyn) should discontinue these for 1 week prior to surgery to decrease the risk of bleeding intra-operatively. In addition blood thinners (such as aspirin, Plavix, or Coumadin) will also need to be discontinued for 5-7 days prior to surgery to decrease the risk of bleeding.
You should have nothing to eat or drink after midnight the night prior to your surgery. Typically you will be instructed to arrive at the surgery center 90 minutes prior to the surgical procedure. You will check in at the surgery center and an IV will be placed.
Surgery typically takes 1-3 hours to complete depending upon the amount of damage within the shoulder and the nature of the procedure that is being performed. During the shoulder arthroscopy, the Phoenix orthopedic surgeon will take pictures of the structures within the shoulder, including the chondral surfaces, labrum, and rotator cuff tendons. Your surgeon will review these photographs with you during your first post-operative follow-up appointment, which should occur approximately 10 days following the surgery.
Nearly all arthroscopic shoulder surgery is done on an outpatient basis. Most patients recover in the recovery room for 45-60 minutes before being allowed to go home. Be sure to have someone with you to drive you home.
Typically a sling is applied following shoulder arthroscopy. Depending upon the nature of the surgery the sling maybe for your comfort only or may be required at all times to protect a repair. Please consult with your surgeon for specific instructions regarding use of the sling following shoulder arthroscopy
The post-operative instructions will depend upon the nature of the procedure performed. For detailed instructions regarding routine shoulder arthroscopy see the post-op shoulder arthroscopy instructions.
What are the potential complications associated with the arthroscopy?
As with any surgery, there are risks associated with shoulder arthroscopy. These occur infrequently and are minor and treatable. Potential problems associated with shoulder arthroscopy include infection (< 1%), stiffness, inadvertent damage to the cartilage surfaces of the shoulder during the procedure, blood clots, failure to eradicate symptoms, and medical complications associated with anesthesia.
Warning signs that suggest a potential complication is occurring include the presence of fevers greater than 101.5°, persistent warmth or redness around the shoulder, increasing or uncontrollable pain, chest pain, or shortness of breath.