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Shoulder Arthroscopy

Arthroscopy is a term used to describe a procedure that orthopedic surgeons use to inspect, diagnose, and repair problems that occur inside the joint.

The word “arthroscopy” is derived from two Greek words, “arthro” (joint) and “skopein” (to look). Translated literally, these two words mean “to look within the joint.” In terms of shoulder arthroscopy, your surgeon will insert a small camera, known as an arthroscope, into your shoulder joint. The camera will stream pictures to a television screen that your surgeon will use to guide small surgical instruments.

Because the arthroscope and accompanying surgical instruments are so small, your surgeon needs only very small incisions (cuts), rather than the larger incisions needed for traditional open surgery. All of this results in less pain for patients and does well to shorten the recovery time endured, ultimately allowing patients to return to normal activities.

Believe it or not, shoulder arthroscopy has been performed since the 1970s. Through the years, it has made the diagnosis, treatment, and resulting recovery from surgery easier and quicker than ever thought possible. Improvements to this procedure occur annually as new medical equipment and techniques are developed.

 

Surgical Procedure Without Rotator Cuff Repair

Positioning and Preparation

When you arrive at the operating room, you will be positioned in such a way that your surgeon will be able to easily adjust the arthroscope in order to attain a clear view inside the shoulder. The two most common positions for a patient undergoing arthroscopic shoulder surgery include:

  • Beach chair position–A semi-seated position that resembles sitting in a reclining chair.
  • Lateral decubitius position–The patient will be laying on their side.

The type of position utilized will depend on the type of procedure being performed as well as the surgeon’s preference.

Once you are laid in the proper position, the surgical team will remove hair—if needed—and follow that up by spraying an antiseptic solution over your shoulder in order to clean and sanitize the skin. After this, your shoulder and arm will be covered with sterile drapes and your forearm will be placed in a holding device to ensure that your arm remains still during the procedure.

 

Procedure

During the first stages of the procedure, your surgeon will inject fluid into the shoulder in order to inflate the joint. This will make it easier for the surgeon to see all the structures of your shoulder through the arthroscope. Your surgeon will then make a small puncture into the shoulder in order to insert the arthroscope. Fluid is able to flow through the arthroscope so that a clear view can be maintained and so that bleeding can be controlled. Images from the inserted arthroscope will project onto the video screen, displaying your shoulder and any damage. 

Once your surgeon has identified the problems with your shoulder, he or she can then insert small instruments through another incision in order to complete the repair. These specially-designed instruments perform tasks such as shaving, cutting, grasping, suture passing, and knot tying. Often times, special devices are used to attach and anchor stitches to bone. 

After all of this, your surgeon will close your incisions with a few stitches or steri-strips (tiny band-aids) and cover them with large, soft bandage.

Surgical Procedure With Rotator Cuff Repair 

In the case of a torn rotator cuff, your doctor may recommend that you pursue arthroscopic surgery in order to fix the tear. During an arthroscopic rotator cuff repair, your surgeon will insert an arthroscope into your shoulder joint. The inserted camera will stream images onto a television screen, allowing your surgeon to guide and use mini surgical instruments.

Being that arthroscopic repair is the least invasive method used to repair a torn rotator cuff, most procedures are performed on an outpatient basis, meaning you can return home the same day you are operated on.