Do you also experience unbearable pain when you lift your shoulder or use your arm? Maybe when you change clothes, take something from a shelf, or just when you lift your arm, do you feel like you are being stabbed from the inside of your shoulder? Even after taking medicine and undergoing physical therapy, this pain has not subsided? Then perhaps your doctor has told you about a 'Shoulder Arthroscopy'. Many people also call this 'key-hole surgery'. So let's talk about this simply, in a way that you can understand.
What is Shoulder Arthroscopy?
Simply put, Shoulder Arthroscopy is a minimally invasive surgery used to diagnose and treat problems in the shoulder. Instead of making a large incision like in a typical open surgery, only a few small keyhole incisions are made.
Imagine that your doctor wants to see what's going on inside your shoulder joint. He inserts a thin, pencil-shaped instrument called an arthroscope through this small incision. It has a tiny camera and a light on the end. The images from this camera are magnified on a video screen outside. It's like watching TV.
After looking inside the joint and finding out exactly what the problem is, they insert very delicate surgical instruments through another small incision and perform the repair inside the joint. This will relieve your shoulder pain and restore normal movement.
Why is this surgery performed and for what conditions?
Typically, we first try non-surgical treatments for shoulder pain. That means:
- Physical therapy
- Painkillers (Medication)
- Injections into the joint
- Rest
However, if none of these things help with the pain, your doctor may recommend a shoulder arthroscopy as the next step. This surgery can remove the swollen tissue in your shoulder and address many other issues.
| Condition being treated | A simple explanation |
|---|---|
| Rotator Cuff Tears | Tearing of the muscle tissue around the shoulder that helps raise the arm. |
| Shoulder Impingement Syndrome | Pain caused by tissue pinching between a bone and a muscle in the shoulder when raising the arm. |
| Frozen Shoulder | The shoulder joint is stuck and feels so painful and stiff that it is impossible to move it. |
| Labrum Tears | Tear of the cartilage ring (labrum) around the shoulder joint. |
| Shoulder Instability | Looseness or frequent dislocation of the shoulder joint. |
| Bone Spurs | Unnecessary growth of extra bone fragments in the bones of the joint. |
| Osteoarthritis | The wear and tear of the cartilage in the joint due to age or an accident. |
What happens before the surgery?
Once your doctor has decided to perform the surgery, he or she will ask about your medical history. You will need to give a complete list of all medications you are taking (even vitamins). You may be asked to stop taking certain medications, such as blood thinners , a few days before the surgery.
The hospital will give you specific instructions, such as how many hours before surgery you should stop eating and drinking. In addition, they may also perform several tests to check your health, such as:
- Blood tests
- Chest X-ray
- ECG test (Electrocardiogram)
What happens during the surgery?
Shoulder arthroscopy surgery usually takes less than an hour . During this time, the following things happen:
1. The surgery is performed with you lying down in a semi-reclining position (like a beach chair position) or turned sideways.
2. The surgical team will thoroughly clean your shoulder area with an antiseptic solution.
3. The doctor will then inject a liquid into your shoulder joint. This liquid will make the joint a little bigger and create space, making it easier to see inside with the camera.
4. Now, a small incision about the size of a buttonhole is made and the camera (arthroscope) is inserted through it.
5. Looking at the video screen, the doctor confirms the exact location of the shoulder problem.
6. Then, one or two more small incisions are made, through which delicate instruments are inserted to make the necessary repairs.
7. After the work is done, the small incisions are closed with stitches or small bandages, and a larger bandage is placed on top.
What happens after the surgery and how is the pain?
This is an outpatient procedure . This means you can go home the same evening. You will need to stay in the hospital for about an hour or two after the surgery. During this time, the anesthesiologists will give you pain medication to control your pain. After that, you can go home, but you will not be able to drive. It is best to have a family member or friend come with you. It is also a good idea to have someone stay with you that night if possible.
It's normal to feel some pain during any surgery, but don't worry. The anesthesia team will make sure you're as comfortable as possible.
Most often, during this surgery, you will be given a nerve block injection in your neck or shoulder. This numbs your entire arm and shoulder for several hours. This means you will not feel any pain after the surgery. In some cases, you may be given general anesthesia, which puts you completely asleep.
What are the benefits and risks of this surgery?
Compared to open surgery, Shoulder Arthroscopy has several advantages:
- The pain is less.
- Joint stiffness is reduced.
- The risk of infection is very low.
- The recovery time is short.
- Scars are very small.
Although this surgery is very safe, there are some risks that can occur very rarely.
- Blood clots
- Damage to nerves or blood vessels
- Excessive bleeding or swelling
- Infection
How long does it take to heal and when should I see a doctor?
It can take anywhere from a few weeks to a few months for your shoulder joint to fully heal. This depends on the severity of your shoulder problem and the complexity of the surgery. It is normal to have some pain and swelling in the first few weeks.
Take the pain medication your doctor gives you. Ice packs can help reduce swelling. For the first few days, sleeping in a recliner or with lots of pillows can help reduce pain. Your doctor will often tell you to use a sling to support your arm.
The most important thing is the rehabilitation plan. Doing the exercises your doctor and physical therapist give you exactly, without getting bored, is essential for a speedy recovery.
If you experience any of these symptoms after surgery, you should call your doctor immediately .
- Fever .
- Severe pain that does not subside even after taking painkillers.
- If there is a foul-smelling, discolored fluid oozing from around the wound.
- Numbness or loss of feeling in the hand or fingers.
- If the swelling is increasing day by day.
Take-Home Message
- Shoulder arthroscopy is a 'keyhole' surgery that treats various shoulder problems without a large incision.
- This is safer than open surgery, less painful, and can heal faster.
- For the success of the surgery, it is very important to follow the instructions given by the doctor and physical therapist afterwards, especially the exercises.
- If you notice any unusual symptoms such as fever, unbearable pain, or drainage from the wound, do not delay and inform your doctor immediately.
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