What is Arthroscopic Surgery?
Arthroscopic surgery is a procedure that allows me to look inside your shoulder and completely visualize all of the structures. This technique allows me to accurately diagnose and treat the problems in your shoulder such as a labral tear, cartilage defect, or rotator cuff tear.
When I perform an arthroscopic examination, I make two small incisions in your skin and insert pencil-sized instruments that contain a small lens and lighting system to see inside the joint. The arthroscope is attached to a miniature high-definition camera which allows me to take pictures of the shoulder joint as well as the treatment that I perform.
Why Arthroscopic Surgery?
Prior to the development of arthroscopic shoulder surgery, we could only treat shoulder injuries with open surgery. These procedures were associated with large incisions, prolonged recovery, and less predictable results. With newer minimally-invasive techniques, arthroscopic surgery has become an exciting tool that I use to look inside your shoulder and confirm the diagnosis and treat the problems, often through just a few small incisions. Arthroscopic surgery allows improved visualization of all structures inside the shoulder, and with specialized instruments I can treat the majority of shoulder injuries.
The following are some of the most frequent conditions that I find during arthroscopic examination:
Inflammation of the lining of the shoulder joint
Tears in the shoulder
How is arthroscopy performed?
Arthroscopic surgery, although much easier in terms of recovery than “open” surgery, still requires the use of anesthetics and the special equipment in a hospital operating room or outpatient surgical suite.
A small incision (about the size of a buttonhole) will be made to insert the arthroscope. Several other incisions may be made to see other parts of the joint or insert other instruments. When indicated, corrective surgery is performed with specially designed instruments that are inserted into the joint through the accessory incisions. The repair is performed inside the joint and the incisions are closed with sutures.
I encourage you to vist the Valley Orthopedics website to learn more about your shoulder surgery.
What happens after arthroscopy?
After arthroscopic surgery, the incisions will be covered with a dressing. You will move from the operating room into the recovery room. Most patients need pain medication for the first week or two, although it is not uncommon to have more pain if an injury was treated. Before being discharged, I will give you instructions about care for your incisions, what activities you should avoid, and which exercises you should do to aid your recovery.
During the follow-up visit, I will inspect your incisions, remove sutures, if needed; and discuss your rehabilitation program.
The amount of surgery required and recovery time will depend upon the complexity of your problem. Occasionally, during arthroscopy, I may discover that the injury or disease cannot be treated adequately with arthroscopy alone. The “open” surgery, if previously agreed, can be performed while you are still anesthetized, or at a later date after you have discussed the findings with me.
What are the possible complications?
Although uncommon, complications do occur occasionally during or following arthroscopy. Infection, blood clots, excessive swelling or bleeding, joint stiffness, damage to blood vessels or nerves, and instrument breakage are potential complications, but have been shown to occur in far less than 1 percent of all arthroscopic procedures.
What are the advantages?
Although arthroscopic surgery has received a lot of public attention because it is used to treat well-known athletes, it is an extremely valuable tool for all orthopedic patients and is generally easier on the patient than open surgery. Most patients have their arthroscopic surgery as outpatients and are home several hours after surgery.
Recovery after arthroscopy
The small puncture wounds take several days to heal. The operative dressing can usually be removed a few days after surgery and adhesive strips can be applied to cover the small healing incisions.
Although the puncture wounds are small and the pain in the joint that underwent arthroscopy is minimal, it takes several weeks (6-8, sometimes longer) for the joint to maximally recover. A specific activity and rehabilitation program may be suggested to speed your recovery and protect your future joint function.
It is not unusual for patients to go back to work or school or resume daily activities within a few days. Athletes and others who are in good physical condition may in some case return to athletic activities within a few weeks.
Remember, though, that people who have arthroscopy can have many different diagnoses and preexisting conditions, so each patient’s arthroscopic surgery is unique to that person. Recovery time will reflect that individuality. It is very rare that your recovery will be the same as that of a friend or family member who also had “arthroscopic surgery.”