Arthroscopy is a minimally invasive surgical technique that involves making several small incisions and inserting a fiber-optic device (arthroscope) and tiny surgical instruments to diagnose or treat certain conditions. Connected to a camera that displays images of the internal structure of the shoulder on a computer screen, the arthroscope allows the surgeon to precisely identify and target joint abnormalities. Orthopedic surgeons may perform a shoulder arthroscopy to diagnose and treat several different conditions of the shoulder. With this type of procedure, patients benefit from less tissue damage, shorter recovery times, less scarring and less post-operative pain than traditional open procedures. The use of this technique also avoids cutting any muscles or tendons in order to gain access to the affected area. Arthroscopy is an ideal treatment option for many patients suffering from shoulder conditions.
What are the common injuries that could cause someone to get a shoulder arthroscopy?
It’s estimated that well over 8 million people head to the doctor’s office for a shoulder problem in the U.S. every year, including shoulder and upper arm sprains and strains. Well over half of these visits are for rotator cuff problems.
Most of the problems in the shoulder involve the muscles, ligaments, and tendons rather than the bones. Athletes are especially susceptible to shoulder problems, whether due to impact that forces the joint into an awkward angle, from shearing forces of certain movements such as throwing a curveball in baseball, or from repetitive movements or uses.
Rather than seek help, many people try to “tough out” their shoulder injury. This can aggravate things, and possibly lead to other problems. They can discount issues such as weakness in the lifting ability of an arm as they become accustomed to it.
At Orthopedic Associates of Long Island, our orthopedic surgeons group shoulder problems into the following categories.
- Instability — If the shoulder joint moves or is forced out of its normal position, such as in a check into the boards in a hockey game, this is called instability. This can result in dislocation of one of the joints in the shoulder. Instability can also occur with the stretching of ligaments over time. A separation of the joint will be quite painful. If separation happens more than once and the ligaments have been over-stretched, it can begin to feel as if the shoulder is continually about to slip out of place.
- Impingement — Impingement is caused by excessive rubbing of the shoulder muscles against the top part of the shoulder blade, called the acromion. Impingement occurs as a result of activities that require excessive overhead arm motion.
These are common shoulder injuries that could lead to arthroscopy:
- Biceps tendon injuries
- Bone spurs
- Frozen shoulder
- Labrum tears
- Rotator cuff tears
- Rotator cuff tendinitis
- Shoulder impingement syndrome
- Shoulder dislocation
Candidates for Shoulder Arthroscopy
Shoulder arthroscopy, also known as shoulder scope, is often performed to confirm a diagnosis after a physical examination and other imaging tests have been performed. Some shoulder conditions may also be treated during the same procedure by inserting a few additional instruments into the joint area. Arthroscopy may be used to treat conditions that affect the shoulder joint which may include:
- Rotator cuff tears
- Labral tears
- Impingement syndrome
- Joint arthritis
Arthroscopy provides many benefits over traditional open shoulder surgery, including smaller incisions, less trauma and shorter recovery times.
The Shoulder Arthroscopy Procedure
The shoulder arthroscopy procedure is performed while the patient is sedated under general anesthesia, and is usually performed on an outpatient basis. During the procedure, the surgeon will insert the arthroscope into a tiny incision in order to thoroughly examine the cartilage, bones, tendons and ligaments within the joint. Any damaged areas may be repaired during the same procedure by making several other small incisions through which surgical instruments are inserted. The type of repair performed will depend on the patient's individual condition, but may include removing inflamed tissue, reattaching torn tissue or replacing damaged cartilage. Once the repair is completed, the incisions will be closed with stitches and a dressing will be applied to the area.
Recovery From Shoulder Arthroscopy
After surgery, patients can usually return home the same day, although an overnight hospital stay may be required in some cases. Patients are encouraged to ice the shoulder and keep it immobilized in a sling for about a week. Some patients experience mild to moderate pain after this procedure, and medication is often prescribed to control pain. Most patients can return to work within a few days after their procedure, although physical activity may be limited for a longer period of time. Full recovery from the shoulder arthroscopy procedure may take anywhere from one to six months, depending on each patient's individual condition. A physical rehabilitation program helps patients restore function to the joint and ensure that it heals properly.
Once the shoulder has fully healed, most patients experience restored function, pain relief, improved range of motion and improved stability of the shoulder.
How do I prepare for shoulder arthroscopy?
Although this isn’t “open” surgery, you’ll still need to take the same steps beforehand. That means you’ll stop taking any blood thinners, anti-inflammatory medications, aspirin, and most herbal supplements for a week before your arthroscopy, as these can lead to excessive bleeding. You’ll receive regional or general anesthesia, depending on the expected extent of your surgery, so you won’t be able to eat or drink anything after midnight on the eve of your surgery.
Preparation really needs to be around your home, as you’ll have to perform basically all your tasks with one arm. Anything you need two hands to bring down from cabinets, for instance, should be brought down to the countertop (or have someone else grab them). It’s a good idea to practice performing certain routine tasks, such as brushing your teeth, with the other arm if it’s not your dominant arm. Your arm will be in a sling for at least one week, likely longer.
How long does shoulder arthroscopy usually take?
These are not long procedures, thanks in part to not creating a large incision as in open surgery. At Orthopedic Associates of Long Island, our shoulder arthroscopies usually take about 1 to 1.5 hours.
Risks of Shoulder Arthroscopy
While arthroscopy is considered safer and less invasive than traditional surgery, there are risks associated with this procedure which may include:
- Blood clots
- Shoulder stiffness
- Shoulder weakness
Nerve damage and infection are also possible complications associated with the shoulder arthroscopy procedure.
Is shoulder arthroscopy painful?
Recovery from shoulder surgery involves some pain and discomfort for several weeks after surgery. The amount of pain and the duration depend upon the extent of the repairs your Orthopedic Associates of Long Island surgeon had to make. You will need prescription pain medication for at least the early part of your recovery.
What Should I Do if I Have Lingering Pain After My Procedure?
Although shoulder arthroscopy can seem like a limited procedure, that’s only in the access without an open incision. These are complicated procedures performed by our board-certified orthopedic surgeons. As such, it takes time for your shoulder to fully recover. Of course, there will be initial pain, but you can have pain throughout your recovery, such as after a physical therapy session.
However, if there is constant lingering pain, that is unusual. If you are experiencing that, we need to see you at one of our seven Orthopedic Associates of Long Island locations.
Schedule Your Shoulder Arthroscopy Consult in Long Island
If you are interested in learning more about the Shoulder arthroscopy procedure and are seeking to determine whether you are a candidate, please give us a call at 631.689.6698 to schedule a personalized appointment with one of our experienced physicians today! You can also fill out the form in our contact page, and our staff will assist you with the assistance you need. Our practice has seven locations in the Long Island area.