What Do You Need To Know About Shoulder Arthroscopy?

Shoulder arthroscopy is a surgery that is used to diagnose and treat shoulder problems. The treatment involves making small incisions on your shoulder.

An arthroscopic shoulder surgery is an inpatient procedure, and you can go home the same day. Although full recovery may take a few weeks or even months, exercise and physiotherapy can speed up healing.

Shoulder arthroscopy is one of the most common orthopedic surgeries these days.

What is shoulder arthroscopy?

A minimally invasive procedure used to identify and address shoulder issues is shoulder arthroscopy. Small incisions are needed for minimally invasive procedures than for conventional surgeries. The size of an incision is comparable to a buttonhole. Your surgeon inserts a small camera, called an arthroscope, through a small incision in your skin.

This camera projects images of your shoulder joint onto a video screen. The doctor views these images to locate injury. Should you need shoulder correction, the surgeon will use miniature surgical instruments to restore mobility to your shoulder.

When is arthroscopic shoulder surgery used?

Dr. Raju Easwaran, Senior Consultant, Max Super Speciality Hospital, Shalimar Bagh says, Arthroscopic shoulder surgery is used to treat a variety of common shoulder problems, including bursitis, tendonitis, arthritis, impingement, lateral tears, and shoulder instability/ multiple dislocations.

Shoulder arthroscopy helps doctors in locating and treating shoulder discomfort that has not responded to conventional therapies.

Non-surgical treatments for shoulder pain include physical therapy, medication, injections, and rest.

Injuries that can be treated by an arthroscopic shoulder surgery

Shoulder arthroscopy can remove an inflamed tissue. It can also treat:

• Bicep tendon injuries
• Bone spurs
• Frozen shoulder
• Tissue injury around the shoulder
• Osteoarthritis
• Rotator cuff tears
• Shoulder impingement syndrome
• If the shoulder joint has become loose or dislocated

As with any injury, your doctor will be the best source of advice on the appropriate treatment method for your situation.

Also Read about the shoulder replacement surgery

How is shoulder arthroscopy performed?

Arthroscopy is typically performed in an inpatient surgery setting. The type of anaesthesia used is decided after a discussion between the patient, surgeon, and anaesthesiologist. Two or three small incisions, each the size of 4mm-6mm are needed to insert the scope and any necessary instruments. The joint is filled with sterile fluid to allow the surgeon to see more clearly. Most procedures take less than one hour to perform. Following surgery you may be in a sling or a special shoulder immobilizer' depending on the type of surgery performed. You will be given specific instructions about whether or not you are allowed to move your arm immediately after the surgery.

Rest, icing, and anti-inflammatory medications will help decrease pain and swelling. The surgical area should be kept dry when showering for the first 3-5 days. The modern dressing is waterproof & allows direct showering over the dressing. Patients usually begin light exercise in 1 week.

Return to full activities may take several weeks to several months depending on the type of surgery performed.

What happens before shoulder arthroscopy?

Before shoulder arthroscopy, your doctor will ask about your medical history.

You must tell them about all the medications: you may need to stop some of them before surgery.

The hospital will give you specific instructions, including how long before surgery you should stop eating and drinking.

To fully determine the state of your health , you may also need a:

• Blood test
• Digital X-ray
• ECG

What happens during a shoulder arthroscopy?

Shoulder arthroscopy usually takes less than an hour. During this time:

1. You are in a semi-sitting position (recliner).
2. The hair is shaved by your surgical team (if necessary) and your skin is cleansed with an antiseptic solution. To ensure you remain still, your arm is placed in restraint.
3. The doctor can inject liquid into your shoulder; the fluid inflates the shoulder joint, making it easier for the surgeon to see.
4. Your surgeon will make a small hole in your shoulder, usually about the size of a buttonhole. A small camera (arthroscope) is inserted into this incision.
5. The camera projects images of your shoulder onto a video screen. Your surgeon will use these images to identify the problem.
6. Your surgeon will make tiny incisions in your shoulder and insert tiny instruments.
7. Once your surgical team has finished your surgery, they will close the incisions.

You may have stitches or small bandages with a large bandage over them.

How painful is shoulder arthroscopy?

Unfortunately, all surgeries are painful,so the staff at your hospital makes sure you are as comfortable as possible during the surgery. They will explain and confirm the options with you.

During the shoulder arthroscopy surgery, nerve blocks are often injected into the neck or shoulder. These nerve blocks cause numbness in the shoulder and arm.

They also help in post-surgery pain relief. In some cases, you may be given general anesthesia to sleep during the surgery.

Pain is inevitable during convalescence, do take advice from your doctor about any concerns that you may have while you recover.

Benefits of arthroscopic shoulder surgery

Depending on your condition, a shoulder arthroscopy may be performed instead of open surgery (with a wider incision). Arthroscopy has a lower risk of infection and a quicker recovery time than an open surgery.

Shoulder arthroscopy is also less painful and causes less joint stiffness than an open surgery.

Benefits of arthroscopic surgery compared with older open surgical techniques include:

• Minimal scars
• Minimal hospital stay
• Minimal pain and swelling
• Minimal stiffness
• Minimal risks and complications

What to do at home after a shoulder arthroscopy?

Wound care

• Posterior shoulder arthroscopy: the wound is covered with gauze or bandage.
• They should generally be left in place for 24 hours.
• Because of the large volume of fluid used during arthroscopy, it is normal to see some blood from the dressings.
• If the wound is still bright red despite elevation and icing, call a doctor.
• On the first or second day after the operation, the bandage should be removed, and the wounds are covered with plaster.
• Do not remove paper strips over the incision or cut visible sutures.
• Wounds should be kept dry for 48 hours.
• Unless otherwise stated, five days after surgery, the wound can be uncovered in the shower, but do not rub the area where the wound is.
• The wound should not get wet within three weeks of the surgery, so avoid doing anything that may cause that.
• Once the bandage is removed on the first or second day, ice is applied for 20 minutes, three to four times a day.

Exercise and mobility

First day after surgery, start with the physiotherapy exercises given

• You may use your arm to dress, eat, and clean yourself unless specifically instructed by your doctor.
• Be sure to use and move your hand, wrist, and elbow to reduce swelling in your arm. While exercise is important, do not do more than required.
• You will also receive instructions on gentle range of motion from the night of the surgery
• Passive range of motion (using the other hand to move the operated arm) is always recommended and can speed up recovery.

Precautions

• Anesthetics are used during surgery and may cause nausea for the first 24 hours, should it happen, drink clear liquids only.
• In case of nausea, have only clear liquids.
• The only solid foods that should be eaten are crackers or toast.
• If nausea and vomiting become severe, or the patient shows signs of dehydration (lack of urine), drink more clear liquids.
• Bruises up to the elbow and chest wall are not uncommon.

Medication for pain

• It is not uncommon for patients to experience increased pain on the first or second day after surgery. This is when the swelling is at its peak.
• Using the pain reliever as directed will help control the pain with little risk of complications.
• Taking painkillers before bed will help you sleep.
• It is important not to drink alcohol or drive while taking narcotics.
• You should resume your normal medications for other medical conditions the day after the surgery.
• There are no particular dietary restrictions after surgery, but overuse of anesthetics can cause constipation. A high-fiber diet, plenty of fluids, and muscle activity can prevent that.

Sleep and shoulder support

• Patients generally sleep more comfortably in a recliner or with pillows behind the operated shoulder.
• Some sleep disturbances are common for about two to three-3 weeks after surgery.
• After surgery, wearing a sling for three weeks is common. In some cases, the doctor may ask you to wear the sling longer.

When should I see my doctor?

Talk to the doctor if you have any of the following these symptoms after your surgery:

• High fever.
• Pain persists despite medications
• Discolored or foul-smelling fluid around the wound.
• Tingling or numbness.
• Increased inflammation.

When you can return to your daily life depends on the complexity of your surgery.

If you have had an arthroscopic shoulder surgery, you might be able to resume your normal routine for a few days.

You need more time to recover from complex procedures. A rehabilitation plan usually includes exercise and physical therapy, which can help you heal faster.

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