Shoulder arthroscopy has been performed since the 1970s. It has made diagnosis, treatment, pain management, and recovery time after surgery easier and faster than was once ever thought possible. Improvements to shoulder arthroscopy occur every year as research continues to advance and develop new instruments and techniques.
The word arthroscopy has Greek origin and when broken down literally means “to look within the joint.” In Greek, “arthro” means “joint” and “skopein” means “to look.” During arthroscopy, a small camera called an arthroscope is inserted into your shoulder joint. The camera displays pictures on a video monitor, which Dr. Stowell then uses to help guide his surgical instruments. Smaller incisions are made because the arthroscope and surgical instruments that Dr. Stowell uses are thin.
Shoulder arthroscopy may be recommended by Dr. Stowell if you have chronic pain that does not respond to nonsurgical treatment. Nonsurgical treatment includes rest, medication, change in activity, physical therapy, or injections that can help reduce inflammation and allow injured tissues to heal. Inflammation is our body’s natural reaction to injury or disease. In an injured or diseased shoulder joint, inflammation causes pain, swelling, and stiffness.
Overuse, injury, or age-related wear and tear are common culprits to shoulder problems. Shoulder arthroscopy may help relieve pain and other issues that damage the rotator cuff tendons, labrum, articular cartilage, and other soft tissues that surround your joint. Common arthroscopic procedures include:
- Rotator cuff repair
- Removal or repair of labrum
- Repair of ligaments
- Removal of inflamed tissue or loose cartilage
- Repair for recurrent shoulder dislocation
The Bone and Joints
Highlighting the major components of joints and bones.
Preparing For Surgery
Dr. Stowell may advise you to see your primary care doctor to make sure that you do not have any medical problems that need to be addressed before your surgery. X-rays, blood tests, an electrocardiogram may be needed in order to safely perform your surgery. You will need to inform Dr. Stowell of any medications or supplements that you take. He may advise that you stop taking some of them before surgery.
If you are generally healthy, your arthroscopy will likely be outpatient, which means you will not need to stay overnight at the hospital. The surgery center will contact you ahead of time to provide specific details about your procedure and give you instructions about how to prepare for your surgery.
Before your surgery, the anesthesiologist will discuss your anesthesia options. Shoulder arthroscopy may be supplemented with regional nerve blocks that numb your shoulder and arm. It is injected in the base of your neck or high on your shoulder. Not only will it be effective during surgery, but the nerve block will also help control pain for a few hours after surgery. Dr. Stowell will combine an ultrasound-guided nerve block with general anesthesia. Most arthroscopic procedures take less than an hour; however, the length of your surgery will depend on what Dr. Stowell finds and what repairs are actually needed.
Dr. Stowell will position you in the operating room so that he can easily adjust the arthroscope to have a clear view of the inside of your shoulder. The two most common patient positions during an arthroscopic shoulder surgery are:
- Beach chair position – a semi-seated position similar to sitting in a reclining chair
- Lateral decubitus position – lie on your side on an operating table.
Once positioned, the surgical team will remove hair, if needed, and spread an antiseptic solution over your shoulder to clean the skin. Your shoulder and arm will be covered with sterile drapes, and your forearm may be placed on a holding device to ensure arm stability.
Dr. Stowell may inject fluid into your shoulder to inflate your joint. This will make it easier for him to see all the structures of your shoulder through the arthroscope. Dr. Stowell will make a small puncture in your shoulder (about the size of a buttonhole) for the arthroscope. Fluid will flow through the arthroscope to keep the view clear and control any bleeding. A video screen will project the images captured by the arthroscope showing Dr. Stowell the inside of your shoulder and any damage.
Once Dr. Stowell clearly identifies your problem, he may insert other small instruments through separate incisions to treat it. Specialized instruments are needed for surgical tasks like shaving, cutting, grasping, suture passing, knot tying, and anchoring. Dr. Stowell will close your incisions with stitches or steri-strips.
After surgery, you will remain in the recovery room for 1 to 2 hours before being discharged home. Nurses on staff will monitor your responsiveness and provide pain medication as needed.
Recovery from arthroscopy is often faster than recovery from open surgery; however, it may still take weeks to months for your shoulder joint to completely recover. Pain and discomfort after surgery are a normal part of the healing process. Dr. Stowell will advise you of pain relief techniques such as icing and may prescribe pain medication suitable for you. During the first days after surgery, some patients are more comfortable sleeping in a reclining chair or propped up in bed. Dr. Stowell will likely stabilize your shoulder during recovery with a sling.
A consistent exercise program will help you recover more quickly and enable you to return to your normal daily activities. Rehabilitation plays an important role in helping you regain strength and motion in your shoulder. Dr. Stowell will recommend the rehabilitation plan suitable for the surgical procedure he performed on you. Physical therapy may also be advised to help supervise your exercise program. Following Dr. Stowell’s guidelines and rehabilitation plan is vital to a successful outcome.
Most patients do not experience complications from shoulder arthroscopy; however, if they do, they are usually minor and treatable. Potential risks with arthroscopy include infection, excessive bleeding, blood clots, and damage to blood vessels or nerves. Dr. Stowell will discuss with you the possible implications before your surgery.