SHOULDER ARTHROSCOPY
What is shoulder arthroscopy
Shoulder arthroscopy
like knee arthroscopy is an operative procedure wherein the interior
shoulder joint is inspected with a 4 mm camera and using one or two
similar sized cuts, a variety of surgical procedure can be done.
Why shoulder arthroscopy?
With advances in
orthopaedic technology, modern shoulder arthroscopy allows as a
patient to get a full, fast and almost painless recovery after
surgical procedure. Surgeries that previously required 6 inches long
incision, prolonged hospitalization and blood loss can now be managed
with small 4mm cuts, day care admission and minimum blood loss. That
translates in to a smooth recovery and minimum interference with your
daily routine.
Do you require a shoulder arthroscopy?
Yes you do, if you
have any one of the following conditions.
- Multiple shoulder dislocations
- Major tears of important shoulder muscles (rotator cuff tears) causing pain, especilaly in the night.
- Extra bone growth in the shoulder pressing on rotator cuff and causing pain & weakness (impingement syndrome)
- Frozen shoulder which has not responded to steroid injections and physiotherapy.
Are there any risks or complications that I must be aware of?
Shoulder arthroscopy
is a very safe procedure, but like most surgical procedures, it has
its own set of known complications:
- Swelling over the shoulder accommpanies nearly every surgery. This is because we need to pump in saline in to the joint under high pressure to see it properly and some of the saline gets collected around the joint. This will resolve over a week's time.
- Stiffness of the shoulder will be experienced by most patients initial 2-3 months after the surgery, especially if a pair has been done. Gradual physiotherapy will help you regain strength in 3-6 months after the surgery.
- Apart from these, the risks of anaesthesia, infection, bleeding, etc. Are best discussed face-to-face with your treating surgeon.
How long does it take to recover fully?
For the first 6
weeks after the surgery, your shoulder will be kept immobilized in a
sling. Gentle exercises called pendulum exercises are allowed in this
time period. After 6 weeks the sling is taken off, and gradual
movements and strengthening are begun. Its generally takes you till 3
months after the surgery to get back to normally (the above does not
apply for frozen shoulder release, where full recovery is expected in
1-2 weeks time).
RECURRENT SHOULDER DISLOCATIONS
Why surgery?
Shoulder arthroscopy
in India is most commonly done for multiple shoulder dislocations.
The shoulder is the most mobile joint of the human body and this
mobility comes at the cost of poor stability. There is a tissue in
the shoulder called the glenoid labrum, which acts like a speed
breaker and prevents shoulder dislocations. Once the shoulder
dislocates in any directions due to trauma (ususlly the front) this
speed breaker is torn. That is the reason that once dislocated, the
shoulder keeps on redislocating to the tune of 90%, if the first
dislocation is sustained below 30 years of age. The patient lives in
a continuous fear of his/her shoulder dislocating all the time.What is done in surgery?
When we operate
shoulder dislocations, we aim to reattach the torn portion of the
labrum back to the bone (glenoid). This can be done with tiny 4mm
punctures, using specialized screws called anchors (generally 2-3),
which go deep inside the bone and allow us to stitch the torn tissue
properly.
ROTATOR CUFF TEARS
Why surgery?
The rotator cuff is
the deep muscle of the shoulder. It is responsible for the smooth
movements of the shoulder joints. Patients in whom it is torn are
suddenly unable to lift their shoulders, or are only able to do so
with considerable pain. The arm becomes weak, and in longstanding
cases stiffness and arthritis sets in. There is continuous pain
especially in the night, while lying down on the affected side. It
generally happens in patients who are more than 40 years old, though
young people can also sustain it following an injury due to roadside
accidents or sports.
What is done in surgery?
Surgery for rotator
cuff tears involves removing a little bit of bone from the
undersurface of the shoulder, to create room for the muscle to move
smoothly. Anchors are used (generally 2-4) to reattach the torn
muscle back to where it belongs.
