What is shoulder arthroscopy?
Shoulder arthroscopy or a keyhole operation of the shoulder is a procedure where a small camera is placed inside your shoulder to enable a diagnosis to be confirmed. It is performed as part of a number of shoulder operations including rotator cuff repair, labral repair for dislocations, subacromial decompression, acromioclavicular joint excision and capsular release.
What happens during the operation?
The operation is generally performed as a day case procedure under a general anaesthetic. You may be given antibiotics as you go to sleep to reduce the risk of infection. You may be provided with special stockings and calf pumps during the operation to reduce the risk of blood clots. If you are at increased risk of a blood clot, you may be given a dose of blood thinning medication after the surgery.
A number of small incisions, around 5-10mm long, are made around the shoulder to allow the camera and instruments to be inserted. The structures inside the shoulder are then inspected.
Other individual procedures you have been listed for are then performed as described below:
- In a rotator cuff repair, the torn tendon will be repaired with bone anchors and strong stitches.
- In a labral repair the torn labrum or soft tissue socket is repaired to the bony socket using bone anchors and strong stitches.
- In a subacromial decompression a small amount of bone, including spurs are shaved off from the underside of the shoulder tip to increase the space for the rotator cuff tendons.
- In an acromioclavicular joint excision, the end of the collar bone is removed using a small burr to excise the arthritis and stop the bones rubbing together.
How long will the operation last?
The duration of the procedure will depend upon what you are having done and the complexity of the surgery. This can range from around 45 minutes to 2 hours.
What happens after the operation?
At the end of the surgery, the wounds are typically closed with stitches and dressings applied. These need to be removed around 2 weeks after the operation, an appointment will be made for you.
You will be in a sling and for some operations a strap will be placed around your waist. You will be seen by a physiotherapist on the day of your surgery, who will teach you to use the sling safely, such as getting dressed and sleeping. They will also arrange follow up for you in the community. Duration in the sling will depend upon what operation you have undergone, typically this is between 2-6 weeks.
I will then review you a few weeks after the surgery to assess your progress.
What are the aims and risks of shoulder arthroscopic procedures?
Aims of surgery:
The aim of a shoulder arthroscopic procedure is to improve your pain and symptoms, it will not give you a perfect shoulder.
Risks of surgery:
All operations carry risks, general risks of shoulder arthroscopy are listed below with more specific risks at the end.
Risks include but are not limited to;
- Infection (increased risk if you have diabetes, smoke or are take certain medications)
- Failure of your symptoms to improve
- Worsening of symptoms
- Nerve or blood vessel injury which may lead to permanent loss of function
- Excessive stiffness or a frozen shoulder requiring further treatment (Increased if you have diabetes or have had a frozen shoulder before)
- Sensitive scars
- Need for further surgery
- Heart attack, stroke and blood clots
- Re-tear in the case of rotator cuff repair
- Recurrent dislocation and fracture of the socket in the case of labral repair