SHOULDER ARTHROSCOPY

A Shoulder Arthroscopy is a minimally invasive surgical (MIS) procedure used to investigate, diagnose and treat a shoulder disorder that fails to respond to physiotherapy, medication or other non-surgical treatments.

An Arthroscopy is commonly known as 'keyhole surgery". This procedure provides a surgeon with a quick, easy and clear view of the inside of the shoulder through a pencil slim, high-resolution camera known as an Arthroscope.

There are two types of Shoulder Arthroscopy:

1. Diagnostic Arthroscopy (investigation to find out what is wrong with a shoulder joint).
2. Therapeutic Arthroscopy (correction of an injury or fault within the shoulder joint).

It is most common for these procedures to be provided at the same time.

Why is a Shoulder Arthroscopy performed?

Shoulder Arthroscopy is usually performed in order to investigate and relieve persistent pain, swelling, clicking, catching, dislocation and instability of a shoulder joint caused by either age related wear and tear, arthritis or trauma.
The majority of Arthroscopies are performed on patients between the age range of 20 and 60 years, although much younger and older patients can also benefit from this procedure.

How is a Shoulder Arthroscopy carried out?

A Shoulder Arthroscopy can be performed under General Anaesthetic (you will be asleep) or Regional Anaesthetic (you will be awake). The procedure usually takes only a short amount of time to perform if the injury to the shoulder is of a minor nature (approximately 30 minutes), although repair of a more complex nature can take much longer.

During the procedure two small incisions (cuts) just a few millimetres in length are made either side of the problematic shoulder. These two incisions allow a narrow tube with a camera within it to be inserted into one and a slim tube that will regularly inject fluid and rinse the inside of the shoulder into the other. The injected fluid will allow the surgeon to get a good view of the problem area via the camera lens as he moves it around the inside of the shoulder.

Once the problem is properly identified, another small incision can then be made elsewhere on the shoulder surface (sometimes two incisions are made) in order to insert exceptionally fine instruments into the problematic joint space. With the aid of clear vision via the camera, the surgeon can then guide his fine instruments and gently correct the problem without any need to fully open up the shoulder.
Common corrective procedures performed during an Arthroscopy are:

• Drainage of inflamed joint fluid.
• Removal of torn or loose fragments of cartilage.
• Removal of loose fragments of bone or irregularities caused by arthritis.
• Reconstruction or repair of a fibrosed capsule, torn cartilage or a torn ligament.

At the end of the procedure the small wounds on the shoulder are usually closed with a single stitch and a simple sticky dressing.

How long do I have to be hospitalized?

Following a progressive improvement of mobility and pain control, patients are normally discharged home 4-6 hours after their surgery.

Recuperation

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid complications such as joint stiffness and Deep Vein Thrombosis from developing. It is therefore normal for patients to be encouraged to undertake upper limb physiotherapy exercises and walk a gentle distance just a few hours after surgery.

Over the next 6 weeks patients will be expected to work on improving their own mobility and range of joint movement through dedicated and progressive physiotherapy and by increasing their daily activity levels. Your Consultant Surgeon will then assess your condition and joints range of movement after 1 week and then again after three months. Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work. Patients should expect a continuous and full physical recovery to take up to 6 months to achieve.

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