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Shoulder Arthroscopy
My goal with this brief overview is to better prepare you for arthroscopic shoulder surgery.
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What is arthroscopy and how does it work?
What are the common types of shoulder problems that can be addressed by the arthroscope?
How long does the arthroscopic surgery last?
What are my responsibilities prior to surgery?
What can I expect after arthroscopy?
What is arthroscopy and how does it work?
Arthroscopy is a surgical technique that involves making a small portal in your shoulder without a larger surgical incision. With use of fiberoptic technology an arthroscope, an instrument that allows us to visualize the inside of your shoulder, was designed. The arthroscope is approximately the same diameter as a fountain pen. Usually 2-3 portals through the skin muscle and joint capsule are required to perform arthroscopic surgery of the shoulder. One portal is created for the arthroscope with a series of magnifying lenses that then allow the image to be sent to a television monitor. Water is also pumped through the arthroscope which inflates the shoulder and allows more ease in maneuverability. The other two portals are commonly placed on the side and in front of the shoulder and are designed to remove or repair damaged tissue.
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What are the common types of shoulder problems that can be addressed by the arthroscope?
Impingement/Rotator Cuff Tendinitis: Often times the tendinitis or bursitis occurs within the shoulder as a results of inadequate space between the top bone of your shoulder and the underlying rotator cuff tendon. The arthroscope can be used to remove bone spurs or abnormally shaped bone that can decompress the rotator cuff tendon.
Rotator Cuff Tears: Under surface or small tears of the rotator cuff can be removed or repaired through the use of shoulder arthroscopy. This will allow often times healing underneath the rotator cuff.
Cartilage Tears: The supporting cartilage that deepens the shoulder socket can often times be torn in a traumatic injury and may be repaired through the arthroscope.
Loose Body Removal: The arthroscope is most valuable in removing loose bodies without making a large incision.
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How long does the arthroscopic surgery last?
Every arthroscopic procedure is different depending on the surgical findings but the most common arthroscopic procedures last from 45 minutes to 1.5 hours. The average surgery lasts 1 hour. The length will depend on the underlying pathology and the amount of damaged tissue that requires removal, reconstruction, or repair.
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What are my responsibilities prior to surgery?
We recommend that you do not eat or drink after midnight the night before surgery. In addition 3-5 days prior to surgery we ask that you discontinue all blood thinners, anti inflammatory medication, or aspirin products. In this way you can hopefully avoid any additional bleeding that occurs after surgery. You should shower the night before surgery but we do not require that you shave the operative shoulder. We prefer that you empty your bladder at least an hour prior to the operative procedure.
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What can I expect after arthroscopy?
Immediately following surgery you will have a large bulky dressing over your shoulder. In many of the shoulder surgeries there will be a drain which will exit out usually on the outside of the shoulder and taped in place. The nursing staff in the recovery room and outpatient department will instruct you on proper management of the drain but usually your responsibility is to empty it one time overnight.
- A simple sling is usually provided for the first postoperative night and depending on the type of surgery you are having and the surgical findings you may be instructed to remove the sling after the first postoperative day.
- Medications: Pain mediations are usually prescribed to help you handle the postoperative pain and discomfort.
- You should elevate your head on 4-5 pillows so that your back is 300 from the flat surface. This will allow the blood to drain with gravity back into the heart and avoid excessive bleeding. This should be performed over 72 hours.
- Ice should also be used over the shoulder 20 minutes 4-6 times per day over three days.
Surgical dressing: The surgical dressing will usually be changed the day following surgery where you will be expected to return to the office for an appointment. A new dressing will be placed and should be left on for additional 3 days. After that time the dressing can be completely removed and showers are allowed. No baths or Jacuzzis are allowed for 3 weeks postoperatively. Once the final dressing is removed you will find white steri strips or adhesive type material across the small incisions and these should be left alone and allowed to fall off on their own. Do not pull or pick them off your skin. It usually takes 7-14 days for these steri strips to fall off.
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