Tag Archives: arthroscopic shoulder surgery

Arthroscopic Shoulder Surgery

What Is Arthroscopic Surgery?

Arthroscopic shoulder surgery is more commonly called keyhole surgery. It involves using an arthroscope to diagnose and treat joint problems.

An arthroscope allows surgeons to literally look within the joint, without making large incisions in the skin. (The word arthroscope is derived from two Greek words, arthro or joint, and skopein – to look.)

How Is Arthroscopic Surgery Performed?

An orthopaedic surgeon inserts a narrow tube, containing a fiber-optic video camera, into the shoulder joint area.

The joint is then viewed on a monitor, which is transmitted from the arthroscope. The incision made for arthroscopic shoulder surgery is about the size of a buttonhole, and this procedure works for relatively uncomplicated shoulder problems.

Common Arthroscopic Shoulder Procedures

A variety of joint conditions may be diagnosed or treated with arthroscopic surgery. Along with the shoulder, arthroscopic surgery is also used on knees, ankles, hips, wrists, and elbows. Some common conditions which may be treated with arthroscopic surgery include:

  • Torn ligaments and tendons surrounding joints
  • Bone spurs or loose bone fragments
  • Inflamed joint linings
  • Damaged or torn cartilage
  • Joint infections
  • Removal of inflamed tissue, excessive scar tissue, or loose cartilage
  • Repairing recurrent shoulder dislocation

Some less common arthroscopic procedures may include fracture repair, nerve release, and cyst extension. Many times, arthroscopic shoulder surgery can correct problems such as a torn cartilage ring (labrum), shoulder instability, or damaged biceps tendons. Shoulder impingement, and problems associated with arthritis may also be corrected. Shoulder arthroscopy is sometimes used for rotator cuff tears if the injury is not too extensive.

What happens before Arthroscopic Shoulder Surgery?

The orthopaedic surgeon will obtain medical records from the patient’s primary physician. Some medications may need to be stopped temporarily, prior to surgery. Other diagnostic tests may be ordered also, to insure a safe surgery. Local or general anesthesia will be administered at the hospital, depending on the extent of shoulder surgery you are having.

Local anesthesia is injected to block pain, in a defined area, and the patient remains awake during surgery. A general anesthesia is delivered intravenously, and will put you to sleep through the surgery. If the patient is generally in good physical health, the arthroscopic shoulder surgery can be performed on an outpatient basis, with no overnight hospital stay.

Arthroscopic Surgery Procedure

In the operating room, the patient may be placed in the beach chair position, or the lateral decubitus position. The beach chair position is similar to sitting in a reclining chair. In the lateral decubitus position, the patient is on his or her side on the operating table. The position selected, is based on the procedure being performed, as well as the surgeon’s training and preference.

The surgical team will remove any hair around the area to be addressed. An antiseptic solution is then spread over the entire shoulder, to prevent infection. The shoulder is covered with sterile drapes. The forearm is placed in a holding device in order to keep it from moving during surgery.

The surgeon will inject fluid into the shoulder. This inflates the joint so that it is easier to see various structures in the shoulder through the arthroscope. A very small incision is made for the arthroscope. Several separate incisions may be made for small specialized instruments necessary for the procedure. Instruments may be necessary for grasping, shaving, suture passing, knot tying, and cutting. Following surgery, the incisions are closed with stitches, or steri-strips, and covered with a larger bandage.

I hope this helps you to understand what is involved in Arthroscopic Shoulder Surgery. For further information follow the link below to my more detailed article

Link: Arthroscopic Shoulder Surgery

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Kind Regards,
Tim Allardyce DO MCSP SRP

Exercises For Shoulder Pain

Arthroscopic Rotator Cuff Surgery

With Arthroscopic  surgery the Rotator Cuff repair  is done by a series of small cuts around the shoulder. Flexible wires called “portals” are introduced through the cuts. These enable the surgeon to see and assess the shoulder damage.

Removal of spurs from the underside of the acromion and repair of the rotator cuff tear are done through the portals themselves using flexible wires capable of carrying various cutting and suturing instruments within themselves in to the joint. This procedure requires a highly proficient and experienced orthopedic surgeon.

Advantage of arthroscopic surgery

The advantage of arthroscopic surgery is that postoperative pain, recovery and rehabilitation are comparatively better. But open shoulder surgery and mini open surgeries provide assured and long term results, especially if the initial rotator cuff tear is very large.

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Mini Open Repair Rotator Cuff Surgery

Mini open repair Rotator Cuff Surgery is a cross between the open and arthroscopic repair.

With Mini open repair the incision is only about 4 cm long. The deltoid muscle is not cut open in this method. Instead, an arthroscope is used to assess the damage and remove the bony fragments of spurs in the underside of the acromion.

Subsequently, the torn rotator cuff tendon is reattached to the humeral head. The incision is then closed in layers.

An advantage of mini open rotator cuff surgery is that recovery is generally quicker than with fully open surgery.

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Open Repair Rotator Cuff Surgery

In open repair rotator cuff surgery a small incision of is made over the shoulder joint. The deltoid muscle, which covers the shoulder joint, is exposed. It is then cut to gain access to the tear.

Re-attaching of the torn rotator cuff tendon to the bone closes the tear. Any bony fragments or spurs are also removed during the procedure. The deltoid muscle is again sutured together. Then the tissues under the skin, and finally the skin are closed.

The results of open rotator cuff surgery provide are generally very good, but disadvantages are that compared to arthroscopic surgery the postoperative pain can be worse, and recovery and rehabilitation takes longer.

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Rotator Cuff Surgery Options

Shoulder surgery is sometimes necessary to treat rotator cuff injuries such as rotator cuff tears. For example, if the rotator cuff injury is accompanied with a decrease in strength of the affected shoulder joint then the injury may require surgery.

There are three different types of shoulder surgery for rotator cuff injuries. These are

1. Open rotator cuff repair
2. Mini open rotator cuff repair
3. Arthroscopic surgery

In my next posts I will examine these different types of rotator cuff surgery in more detail.

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