Shoulder arthroscopy: a minimally invasive solution for pain relief and improved mobility

The most versatile and common surgical procedure for the shoulder is the shoulder arthroscopy. A minimally invasive technique that allows for the treatment of many ailments, it is a standard skill that orthopaedic surgeons should master. In this article, a consultant orthopaedic surgeon with particular expertise in the upper limbs explains the arthroscopic technique, its applications, and its benefits.

What is a shoulder arthroscopy?

The shoulder is a major ball-and-socket joint that connects the upper arm bone (humerus) to the torso via a junction with the collarbone (clavicle) and shoulder blade (scapula). It is made up of not only the bones, but of soft tissues like cartilage, muscles, ligaments, and tendons. The shallow design of the shoulder enables a large range of movement but also renders it vulnerable to instability and injury.

The shoulder arthroscopy can be applied to treat a wide variety of shoulder injuries and diseases, from which patients may be struggling with limited mobility and shoulder pain. It is also used as part of the diagnostic process in instances where imaging scans and physical exams are not sufficient or inconclusive.

Shoulder arthroscopies can treat:

• Rotator cuff tears
• Tendonitis
• Osteoarthritis
• Frozen shoulder
• Bone spurs (osteophytes)
• Fractures
• Superior labarum anterior and posterior (slap) tear
• Dislocation
• Trauma

What happens during a shoulder arthroscopy?

Before the procedure, the patient is typically put under a general anaesthetic and positioned on the operating bed either lying on their side with the shoulder that is being operated on facing the surgeon, or partially reclining.

The surgeon will make small incisions of around 2cm long around the shoulder, through which they can insert surgical instruments like the arthroscope, which is a thin tube with a camera at the end that projects real-time images to a nearby monitor, allowing the surgeon to look inside the joint and discover or treat the ailment – for example, this could be by reattaching tendons, resetting the humerus into the socket, and removing bone fragments. The surgeon then will close up the incisions with sutures or medical adhesives before dressing the wounds with bandages. They may also inject the incision site with a local anaesthetic to help with the post-operative pain.

Depending on the purpose of the arthroscopy, it normally takes around an hour or two to perform and can be done as an outpatient procedure. After the surgery, the patient will be placed in a recovery room while the anaesthesia wears off. They may feel some discomfort, and pain relief medication can be prescribed as needed. Patients can leave when they feel ready, but they will not be able to drive as that will engage the shoulders too much, so they will need to arrange transport.

What are the benefits of a shoulder arthroscopy?

As shoulder arthroscopy is minimally invasive, it tends to be a preferable option for patients compared to an open procedure. Open procedures require one big incision as opposed to the handful of small ones in an arthroscopic procedure. This means that arthroscopic procedures have a faster recovery time, less scarring, and less post-operative.

What is the recovery process after a shoulder arthroscopy?

Within the first 24 hours, as the anaesthesia leaves the system completely, the shoulder will feel more intensely sore and stiff. Patients will have been advised by their surgeon to not use their arm and how to take care of the wound, and may have to wear a sling for some time to keep it in the correct position.

Recovery can take several months, during which there will be swelling and some residual pain. Patients can alleviate discomfort with cold compresses or ice packs and pain medication.

It is recommended that patients undergo physical therapy to strengthen the shoulder and regain flexibility and range of movement. 

If you are struggling with shoulder pain and stiffness and would like to know more about arthroscopy, you can consult with an orthopaedic specialist on Top Doctors.