Shoulder Arthroscopy: Arthroscopy, or Minimally Invasive “keyhole” surgery, allows the surgeon to look into the shoulder joint, make an exact diagnosis, and treat the condition with an operation that requires very small skin cuts. We use specially made instruments that fit through the small skin incisions and we visualize the shoulder using a camera. Because this technique disturbs the shoulder joint less than open surgery, the hospital stay is shorter and the recovery smoother than with “open surgery”.
There are several conditions that can be treated with shoulder arthroscopic surgery:
Rotator Cuff tears
Shoulder dislocations or instability
Cartilage or labral tears
Loose particles in the joint
You will require some preoperative tests, to ensure you are fit for a general anesthetic. We will ask you to fill in some questionnaires prior to surgery. We are part of an international group who study outcomes of different operations to ensure that surgical outcomes are satisfactory. We get you to fill out similar questionnaires at the conclusion of your treatment. You will be admitted to the hospital on the morning of surgery. You must remove all rings from your hand prior to surgery. There usually will be 3 very small incisions about the shoulder. Occasionally there will be up to 6 small incisions if there are several facets to the surgery. Patients are usually discharged home the same day or the morning after surgery
Arthroscopic Capsular Release is performed for frozen shoulder (adhesive capsulitis) which does not settle with conservative treatment. In this surgery, via 2-3 puncture holes, a radiofrequency device is used to cut through the thick and contracted shoulder capsule which gives an immediate improvement in shoulder movements. As the inflammation is cleared, pain comes down as well. The puncture holes are then closed with 1 stitch each and the arm placed in a sling. Patients are discharged home the same day or the next morning. Aggressive exercises are started. Sling is discontinued in a few days. Stitches are removed at 2 weeks post surgery. Exercises are a must for at least 3 months to maintain pain-free full movements.
Rotator Cuff Repair is needed when rotator cuff tendons are torn as a result of injury, overuse or shoulder impingement. Patients have pain and weakness in lifting their arm. Repair is usually performed by arthroscopic surgery (keyhole technique), rarely open surgery is needed. Using 3-6 small puncture holes we visualize the tear using a camera. Suture anchors – small screws with stitches loaded, are then placed in the bone. Rotator cuff tendons are sewed into the bone using these stitches. Bony arch above the tendons (acromion) is shaved simultaneously to create space for rotator cuff tendons to glide freely – this is called subacromial decompression. After surgery, you are discharged from hospital the same day or next morning. You will be in a sling for a few weeks. Progressive exercises start the day after surgery. It takes at least 3-6 months to get the strength back in your shoulder. You are ready for contact sports after about 9 months after surgery. The suture anchors used are generally made of bioabsorbable materials and do not need to be removed later.