Shoulder arthroscopy . It is a surgery in which a small camera called an arthroscope , which is inserted through a small incision (cut) in the skin, is used to examine or repair the tissues in or around the shoulder joint.
Summary
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- 1 Alternative names
- 2 Description
- 3 Why the procedure is performed
- 4 Risks
- 5 Before the procedure
- 6 After the procedure
- 7 Forecast
- 8 Sources
Alternative names
Anteroposterior repair of the superior glenoid (labrum) impeller; Acromioplasty; Shoulder repair; Shoulder surgery; Bankart operation.
Description
The rotator cuff is a group of muscles and tendons that cover the shoulder joint. These muscles and tendons support your arm in osteoarthritis and help you move your shoulder in different directions. Tendons in the rotator cuff can tear when overloaded or injured. Most people receive general anesthesia before this surgery, which means that they will be unconscious and will not be able to feel pain. Regional anesthesia may also be applied. The patient will have the arm and shoulder area anesthetized so that they do not feel pain in that area. If you receive regional anesthesia, you will also be given medicine to put you to sleep during the operation. First, the surgeon will examine the shoulder with the arthroscope, and then:
- You will insert the arthroscope into your shoulder through a small incision. The arthroscope connects to a video monitor in the operating room.
- It will inspect all the tissues of the shoulder joint and the area above the joint: cartilage, bones, tendons, and ligaments.
- It will repair any damaged tissue. To do this, the surgeon will make 1 to 3 smaller incisions through which to insert other instruments. A tear in a muscle, tendon, or cartilage will be repaired. The damaged tissue may need to be removed.
The surgeon may perform one or more of these procedures during surgery:
- Rotator cuff repair: Muscle edges meet. The tendon is attached to the bone with sutures. Small rivets (called a suture anchor) are often used to help fix the tendon to the bone. Anchors can be made of metal or plastic and do not need to be removed after surgery.
- Surgery for impingement syndrome: Clean damaged or inflamed tissue in the area above the shoulder joint itself. The surgeon can also cut a specific ligament, called the coracoacromial ligament, and shave off the underside of a bone, called the acromion. The spur can be a cause of inflammation and pain in your shoulder.
- Surgery for shoulder instability: If you have a break in the glenoid impeller (labrum), the edge of the shoulder joint that is made up of cartilage, the surgeon will repair it. The ligaments that are attached to this area will also be repaired. Bankart injury is a rupture in the glenoid impeller at the bottom of the shoulder joint. An anteroposterior injury to the superior glenoid impeller involves the labrum and ligament at the top of the shoulder joint.
At the end of the surgery using the arthroscope, the incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take photos from the video monitor during the procedure to show what they found and the repairs they made. The surgeon may need to do open surgery if there is a lot of damage. Open surgery means that a large incision will be made so that the surgeon can reach the bones and tissues directly. Open surgery is a more complicated operation.
Why the procedure is performed
Arthroscopy may be recommended for these shoulder problems:
- Ligaments or a damaged or broken cartilaginous ring (labrum).
- Shoulder instability, where the shoulder joint is loose and slips around too much or becomes dislocated (comes out from arthritis).
- A damaged or broken biceps tendon.
- A broken rotator cuff.
- A bone spuror inflammation around the rotator cuff.
- Inflammation or damage to the joint lining. Often caused by a disease such as rheumatoid arthritis.
- Arthritisof the end of the clavicle.
- Loose tissue that needs to be removed.
- Shoulder impingement syndrome, to open up more space for the shoulder to move around.
Risks
The risks of any anesthesia are:
- Allergic reactions to medications
- Respiratory problems
The risks of any surgery are:
- Bleeding
- Infection
- Blood clot
The risks of shoulder arthroscopy are:
- Shoulder stiffness
- Lack of effectiveness of surgery to relieve symptoms
- Insufficient repair to heal
- Shoulder weakness
- Injury to a blood vessel or nerve
Before the procedure
Tell your doctor or nurse what drugs you are taking, including medicines, supplements, or herbs that were bought without a prescription. During the two weeks before surgery:
- Ask the patient to stop taking drugs that hinder blood clotting. They include acetylsalicylic acid (aspirin), ibuprofen (Advil and Motrin), naproxen (Aleve and Naprosyn) and other drugs.
- Ask the doctor which drugs should be taken even the day of surgery.
- If you have diabetes, heart disease, or other medical conditions, your surgeon will ask to see a doctor who treats these conditions.
- Tell the doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
- If you smoke, try to quit. Ask the doctor or nursing staff for help. Smoking can slow bone consolidation and wound healing.
- Always let your doctor know if you have a cold, flu, fever, herpes outbreak, or any other illness you may have before surgery.
On the day of surgery:
- You will generally be asked not to drink or eat anything for 6 to 12 hours before the procedure.
- Take the drugs that the doctor will recommend with a small sip of water.
- The doctor will say what time you should arrive at the hospital.
After the procedure
Recovery can take anywhere from 1 to 6 months. The patient will probably have to wear a sling for the first week, but if the repair they did is a lot, they may have to wear the sling longer. The patient can take medications to control pain.
The time to go back to work or play sports will depend on what the surgery involved and can range from a week to several months. For many procedures, especially if a repair was performed, physical therapy can help you regain movement and strength in your shoulder. The duration of therapy will depend on the repair that was made.
Forecast
Arthroscopy is an alternative to “open” surgery that completely exposes the shoulder joint. Arthroscopy produces less pain and stiffness, fewer complications, shorter hospital stays (if any), and faster recovery sometimes.
If they did the repair, the body still needs time to heal after arthroscopic surgery, just as it would take time to recover from open surgery. Due to this, your recovery time may still be long. Surgery to repair a cartilage tear is usually done to make the shoulder more stable. Many people fully recover and their shoulder remains stable. But some people may still have shoulder instability after arthroscopic repair.
Using arthroscopy for rotator cuff or tendonitis repairs usually relieves pain, but you may not get full strength.
