Shoulder Arthroscopy

What is shoulder arthroscopy?

The arthroscope is a fiber-optic instrument (narrower than a pen) that is put into the shoulder joint through small incisions. A camera is attached to the arthroscope and the image is viewed on a TV monitor. The arthroscope allows me to fully evaluate the entire shoulder joint, including the ligaments, the rotator cuff, the biceps tendon, the joint lining, and the cartilage surface. Small instruments ranging from 3-5 millimeters in size are inserted through additional incisions to enable the surgeon to feel the joint structures for any damage, diagnose the injury, and then repair, reconstruct, or remove the damaged tissue. Before the development of arthroscopy, large incisions had to be made over the shoulder joint to treat or diagnose injuries. Today’s arthroscopic techniques allow more complete evaluations of the shoulder joint while accelerating the rehabilitation process.

What kinds of procedures can be performed with a shoulder scope?

Shoulder arthroscopy allows the surgeon to view the inside of the shoulder joint, and perform a variety of surgeries. These surgeries include:

  • A complete evaluation of the joint (diagnostic arthroscopy)
  • Subacromial Decompression (in cases of rotator cuff impingement)
  • Repair of a damaged or torn biceps tendon (SLAP repair or biceps tenodesis)
  • Evaluation and repair of the rotator cuff (in cases of rotator cuff tendonitis or tears)
  • Removal of the end of the clavicle (in cases of AC joint arthritis)
  • Repair of torn or damaged cartilage or ligaments of the shoulder in cases of shoulder instability

What are some of the possible complications of arthroscopic shoulder surgery?

While complications are not common, all surgery has associated risks. Possible complications include stiffness of the shoulder after surgery or recurrent pain. Other complications include an infection, bleeding, nerve damage, or problems with the anesthesia.

What kind of anesthesia is used?

Shoulder arthroscopy can be performed with general anesthesia (going to sleep) or regional anesthesia (spinal or epidural block). It is your choice. The anesthesiologist will discuss your options the morning of surgery.

What do I need to do to prepare for shoulder surgery?

Our staff will help to set up the surgery through your insurance company and will instruct you on any paperwork that may be necessary. If you are over the age of 50 or have significant health conditions you may require an EKG and chest X-ray. You may also need to see your internist or family doctor to obtain a Letter of Medical Clearance. The day before the surgery, a member of the hospital or surgery center staff will contact you about what time to arrive for surgery. Do not eat or drink anything after midnight before your surgery.

How long will I be in the hospital?

Almost all patients are able to have surgery and go home the same day. Occasionally, patients will be admitted for an overnight stay.

What happens on the day of shoulder scope surgery?

When you arrive at the hospital, you will be admitted and taken to a preoperative holding area where you are prepared for surgery. You will be asked several times which extremity the surgeon will operate on, this question is asked many times on purpose. Anesthesia will be administered and the surgery is then performed.

After the operation, you will be taken to the recovery room to be monitored. Once the effects of the anesthesia have worn off and your pain is under control, you will be given your postoperative instructions and a prescription for pain medication. Please be aware that the process of checking in, preparing for surgery, undergoing the operation, and recovering from anesthesia takes the majority of the day. It is recommended that your driver bring some reading material for the duration.

What should I do for shoulder surgery aftercare?

Prior to your discharge, you will be given specific instructions on how to care for your shoulder. In general, you can expect the following:

Medication:
You will be given a prescription for pain medication.

Sling:
You will have a sling, which you will use for the first 2 to 4 weeks. You can remove the sling for showering and performing your home exercise program.

Exercise:
Prior to your surgery, you will be instructed on exercises to begin the day after your surgery.

Diet:
Resume your regular diet as soon as tolerated. It is best to start with clear liquids before advancing to solid food.

Ice:
You should apply ice over the dressing for 30 minutes every 1 to 2 hours for several days. Do not use heat the first week after surgery.

Suture Removal:
Absorbable sutures used to close the small incisions do not need to be removed. There may be non-absorbable sutures that will be removed on your first postoperative visit.

Postoperative office visit:
You will be instructed on when to follow up in the office. This is usually 2 weeks after surgery.

Return to school or work:
You can return to school or work within 3-5 days without using the affected side. If you need to use the arm to return, you may be out of work or school for a longer period of time.

What will rehabilitation involve?

The rehabilitation is based on several goals:

  1. Allowing the tissue to heal
  2. Regaining your range of motion
  3. Regaining strength
  4. Returning to full duty at work or returning to sports

When can I return to sports?

In general, you will be allowed to return to sports 3-6 months after surgery. You must have good motion, strength, and control of your shoulder and arm. How quickly you return to sports depends on several factors, including:

  1. Your own rate of healing
  2. The damage found at surgery
  3. If you have any complications (like stiffness)
  4. How well you follow the postoperative instructions
  5. How hard you work in rehabilitation

When can I return to full duty at work?

This depends on what is seen and done during your shoulder arthroscopy. I will talk with you about your return to work status both before and after surgery.

Shoulder Doctor St. Louis

Mark Miller, MD is committed to you — the patient. It is understandable to be anxious about your injury and the need for surgery. As one of the leading shoulder specialists and orthopedic surgeons in the St. Louis area, Dr. Mark Miller has expertly managed countless patients’ shoulder injuries with arthroscopic surgery. You can trust us to answer all questions and provide you with the highest-quality care.

Schedule an appointment to begin your arthroscopic shoulder surgery treatment!

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