An Overview of Shoulder Arthroscopy Surgery

Shoulder arthroscopy is an advanced procedure that assists doctors in examining the shoulder joint and treating it. Your healthcare provider will likely recommend this procedure after trying out other treatments without seeing any improvement. Although this surgery can take up to a few weeks or months for the patient’s recovery in addition to the physiotherapy, arthroscopic shoulder surgery is preferred by doctors over open surgery.

Keep reading to find out what is shoulder arthroscopy, its procedure, recovery time after the surgery, and more.

What is shoulder arthroscopy?

Arthroscopy is an operative procedure orthopaedic doctors use to investigate and treat problems inside a joint. Arthroscopy is derived from two Greek words—arthro meaning ‘joint’ and skopein meaning ‘to look’.

In simple words, shoulder arthroscopy involves treatment and probing of the should joint. The surgeon uses an arthroscope with to examine the shoulder joint from the inside. The arthroscope has a camera, which displays real-time footage on a monitor. The surgeon uses this stream to guide tools and other equipment to manipulate the joint has restore optimum health.

All the tools used are quite thin, allowing the surgeon to perform the surgery with small cuts or incisions. These small incisions make the recovery process fast in comparison with incisions made during an open surgery. The patient also feels less pain post operation with arthroscopic shoulder surgery.

Shoulder arthroscopy is extremely helpful in the diagnosis, treatment, and recovery of a shoulder injury. This technique is constantly being improved with each passing year from the first time it was performed in 1970s.

Many people injure their shoulders while working, playing, or performing other activities. Some injuries are resolved with non-operative treatment methods including medication and physiotherapy, but others require the manual intervention of the orthopaedic surgeon. Thus, making shoulder arthroscopy fairly common.

The shoulder is a complex joint that cannot be easily manipulated. This makes shoulder arthroscopy an extremely important procedure for patients with shoulder injuries.
If you have a painful shoulder injury that is impacting the quality of your life and does not respond to other treatments, your doctor may recommend shoulder arthroscopy. Injured shoulder joints have inflammation that is the cause of pain, stiffness, and swelling in the area. This inflammation can be caused due to overuse and wear and tear related to age apart from injuries. Shoulder arthroscopy may relieve pain and promote enhancement in the motor functioning of the affected joint.

Who needs shoulder arthroscopy?

Some of the shoulder ailments usually begin with mild symptoms, which gradually worsen over time. If you notice any persistent pain in the shoulder or difficulty in performing basic motor functions during the day, it is best to visit an orthopaedic doctor to get it checked. Most cases with mild to moderate symptoms can be treated with non-surgical treatments, including injections to reduce inflammation.

You can avoid going through shoulder arthroscopy if you get the necessary medical attention at the right time. Although the surgery leaves minimum invasion, it is better if you can avoid getting any surgery and the body heals on its own.

What injuries are treated with this surgery?

Shoulder arthroscopy helps doctors in removing inflamed tissue and repairing the joint. The following are some of the common injuries treated with shoulder arthroscopy:

1. Bone spurs
   These are bumps of bone outgrowth that can cause significant pain and restrict range of movement. They can be smooth or hard to touch.
2. Frozen shoulder
   It is also known as adhesive capsulitis and causes pain and stiffness in the shoulder joint. Symptoms may or may not get better over time (about 1 to 3 years).
3. Biceps tendon injuries
   Biceps has two tendons attached to the shoulder on one end. Injuries to this tendon may require a person to undergo shoulder arthroscopy.
4. Labrum tears
   The labrum is a type of tissue that helps in keeping the shoulder joint in place and promotes smooth motion. Tear in the labrum can cause the movement of your arm painful and rugged.
5. Rotator cuff tears
   This is a common injury that involves tear in the group of tendons and muscles surrounding the shoulder joint, which can cause pain and disability.
6. Rotator cuff tendinitis
   In this injury the tendons and muscles surrounding the shoulder joint—rotator cuff—is inflamed or irritated. It is also called shoulder impingement syndrome.
7. Shoulder dislocation or instability
   Instability of the shoulder occurs usually when the labrum or the ligaments around the shoulder are stretched or torn. This allows the shoulder joint to move out of the socket.
8. Osteoarthritis
   This is one of the most common forms of arthritis that occurs when the protective cushioning at the end of the bones wear down over time.

There are other less common procedures performed with the help of shoulder arthroscopy:

1. Nerve release:
   This process helps in relieving pressure from the nerve in and around the shoulder joint.
2. Cyst excision
   Sometimes people get cysts in and around their shoulder joint, which needs manual intervention to remove the cyst.
3. Fracture repair
   In this procedure, shoulder arthroscopy is used to put a staple on the fracture to ensure speedy recovery.

Benefits of the arthroscopic shoulder surgery

Shoulder arthroscopy has many benefits in comparison with an open surgery, including the following:

1. Minimal scarring due to small incisions
2. Lower risk of infection
3. Lower joint stiffness post operation
4. Lower pain post operation
5. Minimal hospital stay
6. Minimal risks of complications for the patient
7. Faster recovery

The doctor chooses an ideal treatment for you between arthroscopy and an open surgery depending on your current medical condition and other factors. If given the choice, you should opt for arthroscopic shoulder surgery due to the numerous benefits it has over an open surgery.

Risks involved with the surgery

Generally, people don’t get any complications from opting the shoulder arthroscopy procedure. However, there are certain risks involved with this surgery as well. Listed below are some of the complications people have a small chance of experiencing due to shoulder arthroscopy:

1. Getting an infection
2. Excessive bleeding
3. Blood clot formation post operation
4. Damage to the blood vessels or nerves in the shoulder region

Your doctor will inform you about all of these in advance and you can discuss any doubts or concerns with them before the surgery.

Preparing for the surgery

As a standard protocol, a few tests are performed along with a physical examination to check the readiness of the patient. Your orthopaedic surgeon may ask you to consult with your primary doctor once if they suspect you have any medical condition that requires treatment before the surgery. The following are some of the tests performed before the surgery:

1. Blood tests including CBC and other critical markers
2. An X-ray of the chest
3. Electrocardiogram or an ECG

If you have pre-existing conditions, such as diabetes, cardiovascular ailments, or other diseases, the doctor may perform a more extensive evaluation of your current health status before the surgery. You can proceed with the surgery only when your doctors gives the green signal.

Recovery time and precautions after the surgery

Usually, the doctor will keep you in the hospital for about a day to monitor your vitals and other pointers before discharging you. How you respond to the treatment and medicine will determine the next course of action for your recovery journey, including getting discharged and going home. Initially, you will have a limited range of motion and you may need support from your loved ones to perform basic tasks, such as dressing up., at home.

Although the recovery period for people who have had shoulder arthroscopy is comparatively less than people who have had an open surgery, it may take anywhere from a few weeks to a few months for your shoulder to completely recover. The doctor will call you in for regular check-ups periodically after the surgery to monitor your progress. You will also need pain relievers in initial stages post operation to alleviate the discomfort.

Additionally, the doctor will likely recommend ice packs to relieve pain and swelling.
For the first few days after the surgery, you may also find it uncomfortable to sleep on your back. Some people also prefer to sleep on the good side or on a reclining chair or sofa. The bandages after surgery will be replaced with fresh (and smaller) bandages after a few days.

The doctor may also ask you to avoid getting the wound wet. Generally, people also use a sling or an immobiliser for about 3 weeks to restrict the shoulder joint’s movement and protect it.

Some people may experience complications after the surgery; thus, it is extremely important to consult your doctor immediately if you notice any of the following symptoms:

1. High fever
2. Foul-smelling or discoloured liquid oozing out of the wound
3. Tingling sensation or numbness in the affected area
4. Persistent pain despite taking pain relievers

Cost of shoulder arthroscopy

The cost of arthroscopic shoulder surgery can vary depending on different factors including the following:

1. Expertise of the surgeon
2. Additional services provided by the hospital to ensure maximum comfort of the patient
3. Location of the hospital
4. Presence of highly infectious pre-existing conditions

On average, shoulder arthroscopy costs in India can range from as little as INR 60,000 to INR 2,50,000. The prices for shoulder arthroscopy are usually higher in metropolitan cities than in cities form the list of tier 3 or lower. However, hospitals in metropolitan cities offer highly advanced technology and other services; thus, while making the decision to get the surgery done in a different city that your hometown, you should consider the quality of treatment and the total cost of the procedure after adding logistics before making a decision.

Rehabilitation after shoulder arthroscopy

Physiotherapy and exercise are as important for your speedy recovery as the surgery itself. The doctor will share a list of few simple exercises with you in one of the consultations after the surgery. Your surgeon will devise a suitable plan for you including appropriate exercises as per the procedure conducted. This exercise plan will help you get back to your normal life faster and improve your mobility.

If you have trouble doing these exercises on your own, you can also seek help from a physiotherapist. Generally, elder people and athletes require additional support in their rehabilitation period. People who have had a complex surgery may also be recommended to take the help of a physiotherapist for supervision to avoid any further injuries to their delicate shoulder. You can also use your other hand, which is healthy, to passively support the movement of your operated arm to speed up the recovery.

Soon after starting the exercises, you will be able to perform more and more motor functions on your own without support. Exercising regularly will not only help you recover fast but also aid reduce the swelling.

Outlook for patients who have had shoulder arthroscopy

Depending on the individual’s health, pre-existing diseases (if any), and other factors, the recovery time for every person will be different. In general, people with a minor repair surgery recover fast and do not require any additional support in the long term. However, people who undergone a complex surgery may have some long-term effects on their life; for example, athletes may be asked to change their profession to prevent further/permanent damage to their shoulder.

Although shoulder arthroscopy is an effective procedure used to treat many shoulder injuries, it is important that you follow your surgeon’s guidelines post operation as well. This will help you avoid any complications that may arise and restore optimum health.