Shoulder Arthroscopy Surgery
If you’ve recently injured your shoulder, then you and your doctor are likely discussing a treatment plan for the best way to treat that injury and recover as quickly as possible. While some shoulder injuries can be treated with a sling and rest, others may need surgery to repair the damage.
In the case of surgery, an orthopedic surgeon will devise the least invasive way to repair your shoulder so that you can get back to your life as quickly as possible. Often, that surgery will be performed arthroscopically. Learn more about arthroscopic shoulder surgery, what is involved, conditions that can be repaired, and the recovery period afterward.
What is arthroscopic shoulder surgery?
There are several types of shoulder surgeries, but this type of surgery is often a preferred choice as it is minimally invasive, meaning the surgeon does not have to cut too much at all to repair the issue with your shoulder.
If you know your Greek root words, then you’ll know that the word arthroscopy comes from two root words: arthro and skopein. Arthro translates to joint, and skopein means to look inside the joint. In arthroscopic surgery, the surgeon makes tiny incisions, then uses a small camera to examine the area. The footage from the camera is displayed on a screen, and the surgeon uses tiny instruments to fix and repair your shoulder joint.
Is shoulder arthroscopy a major surgery?
Shoulder arthroscopy is generally considered a minimally invasive surgery, rather than a major surgery. Orthopedic surgeons use small incisions and tiny instruments to diagnose, inspect, and repair tissues inside or around the shoulder joint with minimal disruption to the surrounding tissues.
Key advantages of shoulder arthroscopy over traditional open surgery include:
- Smaller incisions
- Less tissue damage
- Reduced pain and swelling after surgery
- Faster recovery time
However, specific recovery times and outcomes can vary per patient depending on the extent of the repair needed and other factors such as the patient's overall health and adherence to post-operative care instructions.
Injuries that could require a shoulder arthroscopy
If you hurt your shoulder during a fall, playing a sport, or in a car accident, then you may end up needing surgery to repair the damage. It is common to injure a shoulder during a high-impact sport, such as football or hockey. Slip and fall injuries are also very common and can lead to complications. Here are some types of injuries that may require arthroscopic surgery.
Dislocated shoulder
A shoulder dislocation happens when the upper arm bone comes out of the socket of your shoulder joint. There are both partial and full shoulder dislocations and each will require rest and varying forms of treatment.
Shoulder arthritis
Shoulder arthritis occurs when the cartilage surrounding your ball-and-socket joint begins to break down over time, causing the joint to end up with bone-on-bone contact. There are five types of shoulder arthritis: avascular necrosis, posttraumatic arthritis, rotator cuff tear arthropathy, rheumatoid arthritis, and osteoarthritis.
Shoulder separation
A separated shoulder is not the same as a shoulder dislocation. There are varying degrees of severity when it comes to this injury. It involves the ligaments that hold your shoulder to your collarbone — if they are torn, then your shoulder becomes separated.
Rotator cuff tear
A rotator cuff tear can be caused by injury or degeneration. The rotator cuff serves to keep your arm bone attached to your shoulder socket. It also helps you lift your arm and move it around. When this tendon is injured, it’s harder to move your arm and you can lose range of motion.
Shoulder labral tear
The labrum is a part of the cartilage that helps strengthen your shoulder joint. Any type of shoulder injury can cause a shoulder labral tear. In some cases, it can be degenerative in nature.
When you may need arthroscopic shoulder surgery
If your shoulder injury is very severe, then you may have to skip the non-surgical treatment options and go straight to surgery to repair your shoulder so that you can heal as soon as possible.
If your injury is not as severe, then there are other options to try first to reduce the inflammation and relieve the pain. Generally, after you receive a shoulder injury, your doctor will take all the steps necessary to try and treat the injury without going right to the surgical option. This will involve resting your shoulder for a few weeks, keeping it in a sling for a bit, using ice, and other treatments such as physical therapy.
Sometimes, however, these methods won’t work to fix the injury. In this case, your doctor may refer you to an orthopedic surgeon so that they can further examine your shoulder and decide on the best option, which may be arthroscopic shoulder surgery.
Common types of arthroscopy surgery may include procedures to:
- Repair a rotator cuff injury
- Repair a labral injury or remove the labrum
- Repair torn ligaments
- Repair a fracture
Arthroscopy will generally not be used for surgical treatments that involve shoulder replacement, as that is a more invasive surgery that requires more of the area to be opened up so that the orthopedic surgeon has room to work.
How to plan for arthroscopic shoulder surgery
Once you are referred to an orthopedic surgeon, your surgeon will likely consult with your primary care physician to see if you have any risk factors such as cardiac disease that will need monitoring during the surgery, or to determine what medicines you may be taking. Depending on the type of medicine, you may be required to stop taking it in the days or weeks leading up to your shoulder arthroscopy.
If you do not have any known risk factors, your arthroscopy will probably be conducted at an outpatient treatment center, as you more than likely will not have to stay overnight for observation. Your orthopedic surgeon and their staff will inform you of pre-surgery procedures, which may include rules about not eating or drinking anything several hours beforehand. This is because your surgeon may place you under general anesthesia during the surgery, depending on how long they think it may take, according to Dr. Vladimir Alexander, founding partner of Alexander Orthopaedics:
An arthroscopy is an outpatient procedure, so the patient is in and out the same day. It’s done under general anesthesia, so the patient is asleep. In addition, the patient gets a nerve block, called an interscalene block, where the anesthesiologist gives them a shot in the upper part of the shoulder and lower part of the neck, so numbing medicine goes around the nerve and numbs the entire arm so that when they wake up, they’re not in pain. A shoulder arthroscopy operation takes anywhere from 45 minutes to an hour and a half, depending on what has to be done.
What to expect during surgery
Right before surgery, your orthopedic surgeon will position you either on the operating table or sitting up, depending on your surgeon’s preference. The surgeon will then cut a small hole in your shoulder to insert the arthroscope, using the camera to inspect the damage as much as possible. After your surgeon determines the full scope of the damage, they will insert other instruments through other small incisions they make in your shoulder so that the damage can be repaired efficiently.
What happens after the surgery
Once the surgery is completed, expect to stay at the outpatient center for a few hours so that nurses can monitor you and give you any needed pain medication. You will need to have someone drive you home and be with you the first night home.
What pain medication is given after arthroscopic shoulder surgery?
Most arthroscopy patients can manage pain post-surgery with nonsteroidal anti-inflammatory drugs (NSAIDs). If your pain after is persistent, your doctor may prescribe a low dose of a stronger prescription pain medicine to be taken for a few days until you can switch to NSAIDs.
How do you sleep after arthroscopic shoulder surgery?
While you’re recovering from a shoulder arthroscopy, you may need to temporarily alter your sleeping arrangements. Lying flat on your back may cause pain and strain on your shoulder. Sleeping in a reclined position the first week or so after may help. You can accomplish this by sleeping in a fully reclined chair or by propping up some pillows behind your head and shoulders and beneath your knees.
How long does it take to recover from arthroscopic shoulder surgery?
With any type of surgery, recovery is not an overnight process. Although arthroscopy is less invasive, there is still a significant recovery period after. For arthroscopic shoulder surgery in which anything needs to be stitched or repaired, patients usually need to keep their shoulder in a sling for about 4 weeks after surgery and physical therapy, which begins within 2-3 days after the procedure, lasts about 3 months. If no stitching needs to be done during the procedure and the shoulder joint just needs to be cleaned out, patients can expect to wear a sling for about 7-10 days and attend physical therapy for about six weeks. Either way, you may experience some discomfort or pain for several weeks after the surgery, and complete recovery may take a few months.
Do you need a sling after a shoulder arthroscopy?
Yes, patients will always have to temporarily wear a sling after a shoulder arthroscopy. Depending on what had to be done to repair the shoulder joint during the procedure, that amount of time could last from about a week to a little over a month. Shoulder slings are also often necessary for other kinds of pre-surgical shoulder treatments.
What is the fastest way to recover from arthroscopic shoulder surgery?
There are some things you can do to try and aid your recovery. The first is to make sure you follow all your post-operative instructions. Your surgeon will provide you with a set of guidelines for caring for the incision site and a list of activities to avoid. Follow the guidelines precisely to speed your recovery.
The biggest aid to your recovery will likely be physical therapy. As long as you follow the regimen prescribed by the physical therapist and keep at it with assigned exercises, your shoulder should regain strength sooner.
Learn more about arthroscopic shoulder surgery
The team at Alexander Orthopedics has helped many patients with shoulder injuries by performing shoulder arthroscopy surgeries. If you suffer from a shoulder injury and need to see an orthopedic surgeon, we may be able to help you. We’ll consult with your physicians, meet with you, and create a shoulder treatment plan that is well-suited for you and your lifestyle. Contact us today to set up an appointment so that you can meet with one of our skilled medical professionals as soon as possible. We’d love to help you get back to your life and recover from your injury.
Schedule an appointment today and we will contact you within 24 hours to discuss your shoulder treatment plan.