Shoulder Arthroscopy: Conditions Treated
You will be given instructions for how to prepare for your arthroscopic surgery and when you should arrive at the hospital or surgery center. Arthroscopy uses a thin tube with a light and camera on the end to look into your joint area. Other thin tubes are inserted through small incisions to guide surgical instruments. Just before surgery, a healthcare provider will talk to you about the anesthesia that will be used to keep you free of pain during surgery. Be sure to tell your surgeon about any medicines you take including over-the-counter medicines, vitamins, and supplements. You may be asked by several people to confirm which shoulder is being operated on. This is for your safety. Arthroscopy can be used to both diagnose and treat your shoulder problem during the same surgery. Below are common shoulder problems and how they are treated during arthroscopy.
Repeated overhead movements can inflame your rotator cuff and bursa. A bone spur may also form. This causes pain and problems with certain arm movements. Impingement is also called bursitis or tendinitis.
During surgery, an inflamed bursa may be removed. Bone may be trimmed. And the coracoacromial ligament may be detached. These steps make more room, relieving pressure and allowing the arm to move more freely.
Torn rotator cuff
A rotator cuff can tear due to a sudden injury or from overuse. This can cause pain, weakness, and loss of normal shoulder movement.
During surgery, torn rotator cuff tendons may be trimmed. The tendons are then reattached to the humerus. This is done with stitches, anchors, or surgical tacks.
A stretched capsule will remain loose. A loose capsule can’t hold the joint firmly in place. The bones of the joint may feel like they move too much and the shoulder can dislocate.
During arthroscopy, a stretched capsule is folded over itself and sutured in place. (This is done from inside the capsule.) This tightens the capsule, helping make the shoulder joint more stable.
The shoulder is a ball and socket joint. The labrum normally supports and cushions the shoulder joint. In the case of a torn labrum, the socket that the ball (the upper end of your arm) fits into is not very deep. The shallow socket increases the potential for instability.
The labrum may tear off the rim of the glenoid. This can cause the joint to catch or feel like it’s slipping out of place. The shoulder may even dislocate.
A torn labrum is repaired by reattaching it to the glenoid. This is often done with special anchors put into the glenoid bone. Sutures attached to the anchors are tied to hold the labrum in place. The joint is then more stable.
Arthritis and loose bodies
Arthritis is damage to joint cartilage with age and use. Injury or disease can also cause it. Wear and tear may also lead to loose bodies (pieces of bone or cartilage) or bone spurs in a joint.
During surgery, bone spurs are removed. Rough parts of the joint are smoothed. Any loose body is removed from the joint. Bone may also be scraped or shaved to promote new cartilage growth.
October 18, 2017
Canale S. Campbell's Operative Orthopedics. 2013, ed.12, pp. 2467-2557.
Hanrahan, John, MD,Joseph, Thomas N., MD