If a patient is having problems with a joint, then a surgeon may use an arthroscopic procedure to explore, diagnose, and treat the affected area. In particular, a shoulder arthroscopy (SA) involves repairing the shoulder joint as well as the area surrounding the rotator cuff.
During an SA, the performing surgeon inserts a small camera into the affected joint. This camera is called an arthroscope, and it is used to aid the surgeon with navigation during the procedure. The camera accomplishes this by streaming live images of the body in real time during the SA. Using the images provided by the arthroscope, the surgeon is able to guide miniature and highly specialized implements with safety and ease.
An SA is a minimally invasive procedure that opts for smaller incisions as opposed to larger ones, like those used during open surgery. This is made possible because the instruments employed during this class of procedures are both small and thin. Naturally, these attributes make these tools highly mobile and versatile for treating a variety of shoulder problems. Additionally, these smaller incisions result in reduced pain for patients, as well as shorter recovery times.
If you have a painful condition that does not respond to conservative treatments, then your doctor may recommend an SA. Specifically, conservative treatments include interventions like physical therapy, anti-inflammatory medications, or rest.
In many cases, the natural consequences of the aging process are one of the most common reasons why patients seek a shoulder arthroscopy. Likewise, certain age-related conditions such as diabetes can lead to shoulder pain. In addition, athletes or manual laborers may have issues that arise because of injury or overworking the shoulder joint.
An SA may provide relief for many of these problems, such as strain or age-related degeneration, that damage the parts that make up your shoulder. Shoulder structures that your surgeon can repair using a shoulder arthroscopy include:
Some procedures, such as full shoulder replacements, are only possible through traditional open surgery. That being said, there are still many problems that are repairable with an SA. These causes of shoulder pain include:
Though not as common as the above examples, a surgeon will sometimes perform an SA to repair fractures and remove cysts.
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As discussed, one of the main benefits of an SA is its minimally invasive nature. Minimally invasive procedures boast a set of advantages over traditional open surgeries. This is because of the inherent nature of using smaller incisions to explore and repair problems. The common advantages of a shoulder arthroscopy over open shoulder surgery include:
Complications from these types of surgeries are much rarer than they are for traditional open procedures. That being said, complications are always present with any surgical procedure. For SAs, possible complications may seldom include:
Most commonly, however, patients who continue to experience pain after an arthroscopic procedure are actually experiencing the early signs of shoulder arthritis.
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The answer to this question will always depend on a case-by-case basis. You should consult with your doctor to see if your condition qualifies you for a procedure such as an SA. In most cases, your surgeon will need to obtain an extensive medical history from your primary care physician. This is performed as a precaution and to eliminate any other medical problems that need to be addressed before your surgery. If you have certain health conditions, for example, your surgeon may require a more extensive examination prior to the procedure. This may include blood tests, x-rays, or an electrocardiogram. Additionally, your surgeon may or may not need you to stop taking certain medications or supplements before your operation.
The hospital or surgery care center responsible for performing your procedure will likely give you specific instructions to follow pre-surgery. It is extremely important to follow their directions exactly—especially if it is necessary to stop food or water consumption the night before your procedure.
Because this procedure requires anesthesia, it is very likely that a staff member will present you with anesthesia options. Most commonly, regional nerve blocks are used to help facilitate an SA. This numbing agent is injected into the body (usually the neck) to reduce pain to the arm and shoulder. Once the surgery is over, the nerve blocks should continue to work for a couple of hours. In addition to nerve blocks, a surgeon may also use a light general anesthetic and/or sedation for the procedure. This depends on the patient’s comfort level as well as the time needed to complete the surgery. While most arthroscopic procedures take less than an hour, the time may be extended depending on the severity of the condition.
Depending on your case, the surgeon may position you in one of two ways. One option is the beach chair position, which is very similar to sitting in a reclined chair. If not that, then you will likely be in the lateral decubitus position. Unlike the other position, which requires sitting, this involves lying down on an operating table.
Once you are in the proper position, the surgeons will remove any hair and sterilize the shoulder. To reduce the chance of infection, the affected area will be covered in sterile drapes. Additionally, the forearm is inserted into a holding device to ensure stability during the operation.
Firstly, the shoulder needs to be inflated in order to make it easier for the surgeons to navigate. Orthopedic surgeons accomplish this task by injecting fluid into the shoulder joint. Once this step is complete, the surgeon will then make a small incision in the shoulder for the arthroscope insertion. As previously mentioned, this device will provide the surgical team with live images of the structures inside the shoulder.
Once the problem has been discovered by the arthroscope, the surgeons will then use small surgical implements to repair it. Generally, these implements are used for grasping, passing, cutting, shaving, tying knots, and suturing. Sometimes, this step will require additional, very small incisions for better access to the affected structures. Once the problem has been addressed, the implements are removed and the incisions are closed with stitches.
Directly following the operation, most patients stay in a recovery room for a period of 1 to 2 hours. If needed, you may be provided with additional medication to help alleviate any undue stress or postoperative pain. Most of the time, your doctor will require an additional person to drive you home after the operation.
As previously mentioned, this procedure is a minimally invasive surgery, so the recovery time is faster than traditional open surgery. While this may be the case, it may still take a few weeks for the shoulder joint to recover its full functionality. It is common for pain to persist for at least a week after the procedure. This, however, is still much better in comparison to older surgical methods. It may be wise to use ice and prescribed pain medications to relieve discomfort and swelling. Pain medications commonly used in the postoperative phase include opioids, NSAIDs, and local anesthetics. If your doctor prescribes opioids use them only as directed as they are highly addictive. If pain and swelling persists past this time period, consult with your doctor.
Once a few days have passed, you should replace your wound dressing with generic Band-Aids. At this point, it is fine to shower with your wound so long as it isn’t draining and you do not scrub it.
Lastly, in most cases, you will need a shoulder sling to ensure that your shoulder is protected from injury after the procedure. For details on how long this is necessary, consult with your surgeon.
Is your shoulder causing you pain and discomfort? If so, you should contact our expert team of shoulder specialists at (855) 586-2615. NJ Spine and Orthopedics specializes in minimally invasive surgeries and individualized care plans to serve your specific needs. Our team consists of experienced and board-certified doctors on whom you can depend. Consult with one of our shoulder doctors in New Jersey, New York, Pennsylvania, or Florida today and request a free MRI review!
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