People turn to shoulder arthroscopy when more conventional treatments don’t work to heal a shoulder injury or ease the pain. This type of surgery is commonly done to repair a shoulder injury because the recovery time, blood loss and risk of infection are less than that of an open surgery. It is a popular procedure to treat a rotator cuff injury, which happens when the tendons in a complex system of tendons and muscles called the rotator cuff are ruptured. Other people have the procedure because they suffer recurrent shoulder dislocations, frozen shoulder or labrum tears. During arthroscopic surgery, the surgeon uses miniaturized tools and an arthroscope, which is a tube with a camera at one end that sends images to a monitor the doctor uses as guidance.
Before the Surgery
The patient will have a consultation with the surgeon before the surgery. The consultation is very important, as it’s a good time to make sure the patient qualifies for the surgery and that it’s the best method of treatment. This is also the time when a customized procedure can be created that aims to restore the patient’s shoulder and alleviate any associated pain and discomfort.
The doctor will tell them to stop smoking and discontinue blood thinning medications or supplements and arrange for someone to drive them home from the facility. Someone also needs to stay with the patient for at least one night when they come home. The patient will also need to prepare their home for their recovery period.
A Closer Look at the Surgery
It’s important to keep in mind that the exact details of each surgery vary from patient to patient based on a number of factors. Below is just a brief overview of what a typical procedure may involve.
If the patient has something like a frozen shoulder, the surgeon generally marks areas of the shoulder and makes openings for the portal placements. One is for the arthroscope and the other is for the shaver. When they are inserted into their ports, the surgeon can see the shaver on a monitor. In some cases, all that needs to be done is for the motorized shaver to remove scar tissue, adhesions and inflammation which limits the patient’s motion. The surgeon may also use an electrocautery instrument to help control bleeding. The doctor inspects the rotator cuff from all sides to make sure that all is well.
If there are bone spurs, the surgeon uses a motorized tool to smooth them away, since this is too tough a job for the shaver. Bone spurs can rub against the rotator cuff and irritate it. The surgeon then rotates the arm to make sure that the shoulder can move freely. In this surgery, the surgeon does not have to suture any surgical wounds save the initial openings.
All during the surgery, the area is flooded with sterile lubricant. During a rotator cuff repair procedure, the surgeon may need to remove bone spurs that have developed in response to the injury. They may only need to shave off a millimeter or two of bone to correct it. This procedure lowers the chances of the tendon rupturing in the future.
The surgeon may need to perform a Mumford procedure during rotator cuff repair. During this procedure, the surgeon removes the outermost portion of the collarbone, or clavicle, to allow the shoulder to move more freely. The procedure is sometimes needed when the patient has a clavicle that’s too large or has a hook at the end. It takes time for the bone to heal. The surgeon is then ready to deal with the rotator cuff injury.
Once at the damaged tendon, any torn fibers are removed by the shaver. The stump of the tendon is also removed until there is some clean tissue. The shoulder bone, which is soft, needs to be prepared for the tendon to be sewn back to it. The surgeon needs to install triple loaded suture anchors.
The sutures are passed one at a time through the rotator cuff. These sutures are called the S.C.O.I. Row repair. The torn rotator cuff is then stitched with a suturing hook. Another suture anchor is installed in the bone, and a second set of sutures is installed. In the end, all of the sutures, some of which were held in colored straws inside the shoulder joint until they were needed, are tied down and knotted using specialized techniques. The knots are permanent, and eventually the body covers them with tissue.
Shoulder arthroscopy is also used to perform a SLAP repair. The SLAP, or superior labrum anterior and posterior, tear is when the labrum, the thick connective tissue that envelops the socket of the shoulder and stabilizes it, is torn.
As with the other procedures, the doctor makes sure the surgical field is as sterile as possible, then makes portals in the shoulder area. A shaver is inserted to clean the damaged labrum down to healthy tissue. The surgeon then creates a surface with a shaver to prepare the glenoid bone, which is the socket that makes up the ball and socket of the shoulder joint.
The Shoulder Arthroscopy Recovery
After the operation, the surgeon typically wraps the post-operative dressings around the shoulder and places the arm in a sling. The patient can be taken to a recovery area and monitored.
Many patients are discharged after just hours at the facility and may be surprised to discover that the arm that was operated on is completely numb from their shoulder to their fingers for a long time. This numbness will go away after in short order. Then, the patient can take any medications as prescribed and apply ice packs to their shoulder as advised. They should complete a full course of antibiotics if the doctor prescribes them. The doctor will also tell the patient when they can resume taking blood thinners or other supplements.
The patient needs to keep the dressings over their shoulder clean and dry, though they can change them in the days after their shoulder arthroscopy. When the dressings are off, the patient should make sure to keep the surgical sites clean and dry as well. The sling, if the patient has one, can be taken off when they bathe or change clothes. The doctor lets them know when they can take the sling off for good.
For the first weeks after the operation, the patient should rest their shoulder as much as possible. They should not use that hand or arm to perform repetitive actions such as typing on a computer and shouldn’t pick up anything much heavier than a juice glass for at least two weeks.
It is normal for the patient to feel tired after their surgery, and they should rest when they need to. Generally speaking, they could return to a desk job within just days, but if their job requires heavy lifting, they might be off work for months.
The patient can eat a normal diet as soon as they’re able. The doctor may recommend a physical therapist to help the patient retain range of motion and strength in their repaired shoulder.
It is important that the patient go to all of their follow-up appointments. Most patients take multiple months to fully recover from shoulder arthroscopy. However, it all depends on the unique case, as every situation and individual is different.
One of the most important things to remember when recovering is to follow all of the provided aftercare instructions. This is the best way to ensure that you are healing as quickly as possible.
Living with a Healed Shoulder
Most people don’t realize the negative impact that an injured shoulder can have until they experience it firsthand. As you may know all too well, living with an injured shoulder and pain in the shoulder can affect just about every aspect of life. It might force you to stay inside on days when you’d rather be out and about with your loved ones. It may even cause you to call out of work due to the pain.
After a full recovery from a shoulder arthroscopy procedure, you’ll be able to live your life again without the pain and hassle associated with a shoulder injury. The benefits of this simply cannot be overstated. Instead of living your life through the lens of having limited shoulder mobility and being in constant pain, you can enjoy a pain-free life without anything holding you back.
Call Us for More Information About Shoulder Arthroscopy
If you have a shoulder injury that’s just not responding to more conservative treatments such as medications, rest and physical therapy, shoulder arthroscopy may be an answer. Let us set up a consultation between you and our surgeon at Angelo Mattalino, MD so that you can learn more information about the procedure and its healing powers. During this appointment, you can ask whatever questions you may have and learn all of the facts about the surgery.
Here at Angelo Mattalino, MD, we are proud to offer shoulder services like the following:
- Arthroscopic SLAP Repair
- Arthroscopic Rotator Cuff Repair
- Arthroscopic Bankark Repair
- Subacromial Injections
- Shoulder Arthroscopy
- Much More!
Dr. Mattalino is a Diplomate of the American Board of Orthopaedic Surgery with years of experience in the orthopedic field. If you have been looking for a skilled surgeon in the Phoenix area, you owe it to yourself to learn more about his services.