Can Shoulder Arthroscopy Help Me?

Traditionally, surgery to repair diseased or damaged structures in the shoulder, such as the rotator cuff or labrum, required a large, open incision, which resulted in postsurgical pain for the patient, as well as a long recovery time and risk of complication. Advances in medical technology now allow people to receive the same treatment without a large incision, a procedure called arthroscopy.

First developed in the 19th century, arthroscopy became widespread during the 1970s with the introduction of miniature television cameras and fiber-optic technology. Initially, the use of arthroscopy was almost exclusively diagnostic (meaning it was used to diagnose a disease rather than treat it), but now it serves a therapeutic purpose. Arthroscopy can treat several joint injuries and is now the most commonly performed orthopedic procedure.

How Does Shoulder Arthroscopy Work?

Instead of one large incision, arthroscopy involves making a series of smaller incisions, called portals, in strategic locations around your shoulder joint. These incisions allow your surgeon to insert tiny tools directly into the joint. One of these tools is an arthroscope, which uses a fiber-optic cable to transmit light into the joint and a small camera to send images back to the surgeon. This allows the surgeon to identify diseased areas in the joint and repair or remove them with surgical instruments that are about the size of a pencil.

What Can Shoulder Arthroscopy Treat?

Shoulder conditions that arthroscopy can be effective in treating include the following:

Recurrent dislocations
Impingement syndrome
Rotator cuff tendon tears
Loose cartilage
Persistent inflammation
Labral tears
Bone spurs

Am I a Candidate for Shoulder Arthroscopy?

As with any surgery, shoulder arthroscopy carries a risk of postsurgical complications. The risk is minimal for arthroscopy patients, with less than 1 percent experiencing complications like damage to nerves or blood vessels, excessive bleeding or swelling, blood clots, or infection.

There are, however, a few circumstances in which a shoulder arthroscopy is not recommended (called a contraindication), such as if a patient has severe arthritis or current infection. If either of these conditions is present in your shoulder, the surgeon may cancel your surgery or postpone it until a later date.

Some orthopedic surgeons consider old age a contraindication for shoulder arthroscopy because of the risk of complications. However, Rush University Medical Center researchers conducted a study that shows the benefits of shoulder arthroscopy in terms of pain relief and improved functioning in elderly patients with shoulder conditions outweigh the potential risks.

What is the Benefit?

Shoulder arthroscopy offers many potential benefits. Most arthroscopies are same-day surgical procedures—it is very rare to have to stay in the hospital even overnight for an arthroscopic procedure. The recovery time after the arthroscopy is usually less than a traditional shoulder surgery as well.

There is also a reduced risk of infection following an arthroscopic procedure, and patients tend to experience less postoperative pain and swelling after an arthroscopy.

If you experience persistent shoulder pain, you should see a doctor. An orthopedic surgeon can review your treatment options with you and help you decide if a minimally invasive arthroscopic procedure would help.