A Guide to Shoulder Arthroscopy

At The Orthopaedic Clinic, we are genuinely concerned that our patient had a full understanding of their injury, treatment options, and the rehabilitation required for a full, speedy recovery.  This handout is meant to complement the information you received during your visit with Dr. Wilson.  We encourage you to read this and feel free to ask any questions concerning your treatment.  Our goal is to help you make a fully informed decision about your shoulder.

The Orthopaedic Clinic is the leading regional center of excellent for sports medicine and arthroscopy utilizing state-of-the-art diagnostic and treatment techniques. Dr. Wilson offers a wide variety of conservative and surgical options for the patient with shoulder injuries. Dr. Wilson has specialty training and extensive experience in the use of arthroscopic surgery to diagnose and treat the injured shoulder.

Our treatment philosophy for all patients is the same as it is for the athletes under our care; we pledge to deliver the highest quality care using state-of-the-art diagnostic and treatment techniques.

What Is Arthroscopy?  

The arthroscope is a fiber optic instrument, narrower than a pen.  It is placed into the shoulder through a tiny incision (portal).  A small camera attached to the arthroscope allows Dr. Wilson to view the shoulder structures on a television monitor.  Using additional portals, small instruments ranging in size from 3 to 5 mm are inserted into the shoulder.  These instruments allow Dr. Wilson to inspect and feel the joint structures, more accurately diagnose the injury, and then clean up, or repair and/or reconstruct the damaged structures.

In the past, many orthopaedic injuries required complicated operations with large incisions, long hospital stays and extensive physical therapy.  Today, many procedures are done entirely or in combination with the arthroscope, allowing for more accurate diagnosis, less invasive surgical intervention, and an accelerated rehabilitation process. It must be kept in mind that not all surgery can be done through the arthroscope.

What Types of Procedures Can Be Done With Arthroscopy?

Some of the more common arthroscopic procedures in the shoulder are debridement or cleaning up of partially torn structures, such as the rotator cuff, labrum, biceps tendon, ligaments or cartilage. Other procedures include removal of inflamed joint lining (synovectomy), removal of loose bodies, treatment of arthritis.  Other procedures include treatment of impingement or rotator cuff tendonitis and repair and/or reconstruction of a torn rotator cuff and/or biceps tendon.  There are also procedures to treat instability of the shoulder involving a torn labrum and/or ligaments or stretched out or torn capsule.

Shoulder Anatomy

The humeral head is the ball at the top of the humerus (arm bone). The scapula is the shoulder blade.  The coracoid and acromion are two parts of the scapula.  The glenoid is a shallow socket on the scapula.  The labrum is a ring of cartilage around the rim of the glenoid.  The clavicle is the collarbone.

The soft tissues around the shoulder include muscles, tendons and ligaments.  These structures connect the shoulder bones together and provide stability and power in order to move the joint.  The rotator cuff is made of both muscles and tendons.  These muscles and tendons connect the shoulder bones and move the joint. The bursa is a fluid-filled sac that cushions the rotator cuff.  The capsule is a sheet of tough fibers that enclose the joint.  The capsule attaches to the ligaments and labrum.  The coracoacromial ligament connects the acromion to the coracoid.

The Orthopaedic Evaluation

Your office appointment with Dr. Wilson will include an evaluation of your history and your symptoms and a physical examination of your shoulder.  Diagnostic tests include x-rays and MRIs and CAT scans may be done.  Altogether, these methods of evaluation will allow Dr. Wilson to find the cause of your shoulder problem.

Arthroscopy:  Looking Inside Your Joint

Arthroscopy allows Dr. Wilson to see and work inside the shoulder joint through small incisions as discussed earlier. An arthroscope, which is a long, thin, lighted instrument, is used in order to visualize the shoulder structures. The images are then sent to a monitor and allow him to diagnosis and then treat your shoulder problem.

What Are The Possible Complications?

While complications are not common, all surgery has associated risks.  The possible complications include excessive stiffness after the surgery or pain in the shoulder.  Your rehabilitation after surgery is specifically designed to address these two issues.  Other complications, although rare, can arise from infection, bleeding or blood clots, and/or damage to nerves or blood vessels.

What Do I Need To Do To Prepare For Surgery?

Our staff will work with you to set up the surgery through your insurance company.

Prior to surgery, you may be asked to perform some exercises at home or with a physical therapist.  These exercises may help prepare the shoulder for surgery by trying to maximize the range of motion of your shoulder in order to prevent excessive stiffness.  In cases of shoulder instability, these exercises may try and maximize the strength of your shoulder.

What Type Of Anesthesia Is Used?

General anesthesia and/or regional anesthesia (intrascalene block) can be used for arthroscopic shoulder surgery.  Prior to surgery, an anesthesia provider will discuss with you the various options and answer your questions.

What Happens On The Day Of Surgery?

The day before surgery, you will be told what time to report to the hospital the next day.  It is very important to arrive on time.  You will be admitted to the hospital and taken to a preoperative area where you will be prepared for surgery and then taken to the operating room.

Note: You may not eat or drink anything after midnight the night before your surgery.  If you must take medicine, then you will be permitted to do so with just a sip of water. 

After the operation, you will be taken to the recovery room to be monitored. Here, the staff will check that the effects of the anesthesia are wearing off properly and they will provide you with medication for any pain that you are having.  Most patients go home the same day.  You will be given specific instructions to follow at home and you will be discharged after you have adequately recovered.

Please give Dr. Wilson’s office a call at (334) 749-8303 if you have any questions.