- 26 June 2019
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Shoulder Arthroscopy – A Patient Guide to Shoulder Surgery
Stop bothering about large incisions and recovery time? Worry not the most advanced technique is arthroscopy. Approach Sunshine hospitals Bhubaneshwar- an ultramodern facility in Arthroscopy.
The shoulder is one of the several joints of a human body. The shoulder joint is also the most used joint, also called a ball and socket joint. Shoulders facilitate several functions such as lifting weights, performing overhead tasks/activities, maintaining gait, throwing, pulling, pushing, etc.
As shoulder joint is widely used joint, it is also more prone to injuries when compared to other joints. Earlier, surgery to shoulder joint was cumbersome and required lengthy periods for recovery and for regaining the range of motion of the shoulder. This is not the case now, thanks to the introduction of arthroscopy. This said procedure has brought down the time to perform surgery, hospital stay, and the time to recovery and return to a normal routine.
Let’s get into detail to know more about shoulder arthroscopy, how an when it is performed, post and pre-operative care, and conditions shoulder arthroscopy is recommended.
Arthro means “Joint” and
Scope means “To view”.
Shoulder arthroscopy is a surgical procedure that involves a tiny camera, called an arthroscope, to examine, diagnose, and repair the tissues problems inside the shoulder joint and the space surrounding the rotator cuff. This arthroscopy procedure is done by inserting specialised instruments through a small incision in your skin.
The arthroscope is a piece of pencil-sized equipment that is made up of magnifying lenses, a light source, and water flow where it has a small camera that helps your surgeon to see all the structures inside your shoulder that projects a clear image of the joint to a connected high-definition Television monitor.
The doctor will be able to view the inside of your shoulder joint and identify unravel or worn at the edge by rubbing torn or degenerative tissue. This New invention of shoulder arthroscopic has led to quicker recovery times, faster rehabilitation, and less pain. Before this, let us know the anatomy of the shoulder joint.
What is a Shoulder joint:
The shoulder is one of the enormous most complex joints in the body, called a ball and socket joint where the humerus (upper arm bone) fits into the scapula (shoulder blade). These joints are combined with several tendons and muscles, which helps us to rotate the hand in a circular motion. This Shoulder joint acts as a fulcrum facilitating the rotation of hands in a circular motion, and for performing overhead activities.
It is made up of three bones:
- Clavicle (collarbone)
- Scapula (shoulder blade)
- Upper arm bone called Humerus
- Associated muscles, ligaments and tendons.
When is shoulder arthroscopy recommended :
Some of the problems faced after an injury to shoulder Joint are, pain, stiffness, restricted movement, pain disturbing sleep at night. Shoulder arthroscopy surgery is recommended or advised by your orthopaedic doctors.
to treat a variety of common shoulder problems like:
- Bursitis and Synovitis: The joint lining that covers the tendon becomes inflamed or thickened.
- Bicipital tendonitis: Worn out or inflamed biceps tendon.
- Calcific tendonitis: calcium deposits seen in the rotator cuff tendon
- Rotator cuff tear: It is a tendon structure of the shoulder which is responsible for lifting your arm over your head.
- Impingement: Humeral head and acromion get weakened or narrow. When the arm is raised towards the head, pain is caused.
- Labral tears: Labrum helps the shoulder to keep the shoulder in place. The labrum can wear out, torn or detached.
- Acromioclavicular joint arthritis: The joint between the collarbone and the acromion becomes inflamed or arthritis.
- Loose bodies: A piece of cartilage breaks and float freely in the joint, causing catching and pain.
- Shoulder instability: History of subluxation or dislocations of the shoulder
- Frozen Shoulder: Shoulder joint is not moved for long term causes frozen shoulder
Before suggesting shoulder arthroscopy, the patient is first treated with rest, physical therapy, anti-inflammatory medications, and steroid injections. If the condition does not respond to the above treatment, then shoulder arthroscopy is recommended. After going over the impact of injury, our orthopaedic doctor at Sunshine, Bhubaneswar will advise you on the appropriate treatment.
Planning for Surgery Preoperative Care:
- The orthopaedic surgeon may suggest you after seeing that you don’t have any medical issues that should be attended before the surgery. To perform surgery safely, the doctor may recommend tests such as blood tests, electrocardiogram, and/or chest x-ray. A progressive broad assessment is needed before the surgery if you have certain health risks. Make sure to inform your orthopaedic surgeon regarding medications that you are taking if any. You may need to quit some of these as per the doctor’s suggestions before the surgery.
- The hospital or doctor will get in touch with you to give specific instructions before, about the surgery. Make sure you follow the guidelines provided on when to arrive and particularly on when to quit eating or drinking preceding your surgery.
- Before the surgery, a doctor from the anaesthesia team will talk with you about anaesthesia options. Shoulder arthroscopy is usually performed using regional nerve blocks, which numb your shoulder and arm. This anaesthesia injected in the base of your neck or high on your shoulder, this is the place the nerves that control feeling in your shoulder and arm.
- Most arthroscopic strategies take exactly less than 60 minutes; in any case, the length of your medical procedure will rely upon what your surgeons find and what fixes are required.
How is Shoulder Arthroscopy Done?
Arthroscopy is generally performed in an outpatient setting. The kind of anaesthesia given while performing the arthroscopy is up to the patient, orthopaedic surgeon, and anesthesiologist. A few invasion points, each of the size of a dime, are made to insert the scope and any essential instruments. The joint is loaded up with clear liquid to enable the surgeon to see the surgery joint. The procedure takes less than an hour to perform. Following the shoulder arthroscopy, you might be in a sling or ‘Shoulder immobiliser,’ depending upon the kind of surgery performed.
Symptoms You Notice After the Surgery:
It would be suggested that you take rest after surgery. The below symptoms are normal and should wear off in the next 12 to 20 hours. Symptoms you may notice after surgery are as follows:
- Inability to move your shoulder and hand
- Feeling of numbness in your hand and shoulder
- Voice may become hoarse
- Eyelids may droop
Post Operative Care:
You will be given specific guidelines about whether you are permitted to move your arm following the arthroscopy procedure, and some of the care taken after the procedure.
- Depending on the type of surgery performed, doing full activities may take several weeks to several months.
- To help decrease pain and swelling rest, Icing, and anti-inflammatory medications
- Take care while bathing for the first 3-5 days because the surgical area should be kept dry
- After bathing, simply change the dressings. The patients usually start performing a light exercise in 1 week.
Orthopaedic Improvement after surgery:
- Shoulder Arthroscopy without repair:
- Blanket Repair: Recurrent shoulder dislocation
- Debridement of incomplete rotator cuff tear: calcific tendonitis, labrum or biceps ligament
- Mumford procedure: Resection of the distal clavicle
- Subacromial decompression: Giving more space between the humeral head and the undersurface of the acromion
- Synovectomy or bursectomy: Expelling in aimed tissue from inside the shoulder.
For any of this surgery, to feel the comfort, you will utilise your shoulder immobiliser and stop using it when you feel comfortable. This differs typically relying on the surgery. In the first six months, you can perform early pendulum exercise and passive range of movement. This exercise will eventually increase the active range of motion and strengthening exercises when you feel comfortable, which takes 2 to 3 weeks from the date of surgery.
Benefits of Arthroscopic Surgery:
Compared with older open surgical techniques, the benefits of arthroscopic surgery include:
- Minimal scars
- No overnight hospital stay
- Quicker functional recovery
- Decreased pain and swelling
- Fewer risks and complications
- Improved motion
Shoulder Arthroscopic Surgery – Frequently Asked Questions:
Can I take a bath following the surgery?
Bathing is permitted after 72 hours following surgery, but however, don’t enable the water to hit directly on the incisions points. Don’t wet thoroughly in the water until 21 days after the surgery. This implies no use of a bathtub, hot tub, or swimming in a pool or sea
To what extent will my Surgery take?
Most of the surgeries will take 45 minutes to 60 minutes. You will then sent to remain in the recovery room for about one more hour. After that, You will be discharged to home. Keep in mind that to make arrangements to go home after surgery, as you won’t be driving on the day of surgery.
Will I need to wear a sling following Operation?
This relies upon the kind of surgery that was performed. You have to wear a sling for about fourteen days after surgery for rotator cuff repairs, SLAP repair, and disengagement fixes. A sling might be worn for comfort and can be removed if pain decreases in subacromial decompression surgery.
What Things Can I do after the Surgery?
For the initial 2 weeks following surgery, you ought to stay in the sling consistently except while bathing. You may remove your sling to do pendulum exercises with your shoulder and range of movement exercises with your elbow. For the elbow works out, your arm ought to stay against your body. If anything happens to shoulder and hurts, don’t fear Use ice and rest.
What Things Should I Never Do after Surgery?
For the initial 2 weeks, you ought not to do any active movements with the shoulder. When you start treatment after your first postoperative visit, you will be given guidelines on how to progress your activity. Remember that there is some discomfort involved with therapy! Protect your incisions with sunblock from 3 weeks post operation until a half year post operation. until 4 months of postoperative do not lift, carry, push or pull anything greater than 10 lbs.
As discussed earlier, the shoulder joint plays an important role in performing the majority of our day-to-day activities. It acts as a fulcrum providing leverage to our hands when it comes to lifting weights, holding and carrying objects, and for rotation movements. With the advent of arthroscopy, dealing with shoulder injuries has become relatively easy. Although arthroscopy provides comfort in minimizing the time for recovery, post and pre-operative care play a vital role, which would be detailed by the treating physician. Post-operative side effects are minor in nature and are sure to subside with proper monitoring and care.
The important advantage of this procedure is that it basically projects visuals of the inner of the shoulder joint to the operating surgeon on a television screen, thereby assisting the surgeon to operate accurately.
About Sunshine Hospitals:
Sunshine Hospitals, Bhubaneswar is an ultramodern 125-bed, tertiary care hospital located in the heart of Bhubaneswar. Established in the year 2015 with a mission to provide quality healthcare services to the people of Odisha. Sunshine’s patient-first approach steers it steadily in the direction of ensuring that state-of-the-art technology meets state-of-the–heart services to produce positive patient outcomes.