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 surgical intervention 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 cuts and then uses a 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.
Injuries that could lead to surgery
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. Types of injuries that may require arthroscopic surgery include:
- 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 one will require rest and varying forms of treatment.
- Rotator cuff tear: Your rotator cuff serves to keep your arm bone attached to your shoulder socket. It also helps you to lift your arm and move it around. When this tendon is injured, it is harder to move your arm and you can lose range of motion. A rotator cuff tear can be caused by injury or degeneration.
- Shoulder arthritis: This condition happens 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 labral tear: The labrum is a part of the cartilage that helps to reinforce your shoulder joint, and it can tear when you sustain any type of shoulder injury, or in some cases, it can be degenerative in nature.
- Shoulder separation: A separated shoulder is not the same as a shoulder dislocation, and 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.
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, they 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 (portal) in your shoulder to insert the arthroscopy device, 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 portals 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. If your pain after is quite severe, your doctor may recommend stronger prescription pain medicine, but these should be taken with caution as many can be highly addictive. Many times, arthroscopy patients can manage pain with nonsteroidal anti-inflammatory drugs (NSAIDs).
Consider changing your sleeping arrangements at first — 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’ll also want to wait to shower until your surgical wounds have stopped draining, but do not scrub them or soak them.
How long you’ll need to recover
When any type of surgery is involved, recovery is not an overnight process. Even though arthroscopy is less invasive, there is still a significant recovery period after. “What is done in surgery determines the recovery time,” says Dr. Alexander. “If stitching needs to be done, where anything needs to be stitched or repaired, usually patients need four weeks in the sling after surgery. Physical therapy starts pretty quickly, 2-3 days after surgery, and the patient has about three months of physical therapy in total. If no stitching needs to be done and the shoulder just essentially needs to be cleaned out, then the patient wears a sling for 7-10 days and has about six weeks physical therapy.”
You may experience some discomfort or pain for several weeks after the surgery, and for complete recovery, it may take months. There are some things you can do to try and aid your recovery, though.
The biggest help 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. Without following this, it is less likely that the surgery will be successful.
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.