What is Shoulder Arthroscopy?
Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small cut (incision) in your skin.
The rotator cuff is a group of muscles and their tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in the shoulder joint. This also helps the shoulder move in different directions. The tendons in the rotator cuff can tear when they are overused or injured.
You will likely receive general anesthesia for this surgery. This means you will be asleep and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed, as a result you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.
During The Procedure, The Surgeon:
- Inserts the arthroscope into your shoulder through a small incision. The scope is connected to a video monitor in the operating room.
- Inspects all the tissues of your shoulder joint and the area above the joint. These tissues include the cartilage, bones, tendons, and ligaments.
- Repairs any damaged tissues. To do this, your surgeon makes 1 to 3 more small incisions and inserts other instruments through them. A tear in a muscle, tendon, or cartilage is fixed. Any damaged tissue is removed.
- Your surgeon may do one or more of these procedures during your operation.
Who Requires Shoulder Arthroscopy:
Young individuals– sports injuries, repeated shoulder dislocations
Elderly– diabetic, age related joint degeneration
What are the symptoms:
Acute injury- pain, difficulty in movement
Chronic injury- pain, stiffness.
How to prevent shoulder issues:
Adequate warm up, stretching to maintain good range of movement of joints before playing; maintaining correct posture and technique while playing. Blood sugar control for diabetic individuals. Do not ignore your symptoms. Get yourself evaluated at the earliest by an orthopedic surgeon.
What are the next steps:
Needs immediate attention. Consult an orthopedic surgeon for physical exam.
What investigations are needed:
X-ray to rule out any associated fracture, arthritis, bone overgrowth, dislocation, bone defect and mri scan to identify the exact problem- such as rotator cuff muscle injury, labral injury, arthritis.
Why does a shoulder problem require intervention:
Most shoulder problems like labral tear, muscle tear, joint dislocation, do not improve over time on their own- instead become worse; affecting the patients quality of life.
For partial rotator cuff muscle injury; stable labral injury, arthritis-
Stem cell therapy alone:
- Platelet rich plasma(prp) -implantation of patients own platelets to promote healing.
Bone marrow aspirate concentrate(bmac)- implantation of patients own bone marrow to promote healing.
Gold induced cytokines(goldic)- implantation of patients own blood mixed with gold particles to promote healing.
For Unstable Labral Injury:
Arthroscopy+ labral repair- done in cases where labral injury is unstable, leading to repeated shoulder dislocation. Knotless repair is done using bio-absorbable non-metallic anchors to place the torn labrum back to its original position.
For full thickness rotator cuff muscle injury:
Arthroscopy + rotator cuff muscle repair using bio-absorbable non-metallic anchors- speed bridge system- to place the torn muscle back to its original position.
Arthroscopy+ removal of extra bone and tissue formed due to arthritis.