Shoulder Arthroscopy

What is shoulder arthroscopy?

Shoulder arthroscopy is a minimally invasive surgery used to diagnose and treat shoulder problems. You might have arthroscopy for rotator cuff tears or shoulder impingement. Minimally invasive procedures require smaller incisions than traditional surgery. Each incision is about the size of a keyhole.

Your surgeon inserts a small camera called an arthroscope through a tiny incision in your skin. This camera projects pictures of your shoulder joint to a video screen. Your provider looks at these images to find the source of your injury. If you need a shoulder repair, the provider uses miniature surgical instruments to restore your shoulder’s mobility.

Why is shoulder arthroscopy done?

Shoulder arthroscopy helps healthcare providers find and treat shoulder pain that has not responded to nonsurgical treatments. Nonsurgical treatments for shoulder pain include physical therapy, medication, injections and rest.

What shoulder injuries does arthroscopic shoulder surgery treat?

Shoulder arthroscopy can remove inflamed tissue. It can also treat injuries such as:

• Biceps tendon injuries.
• Bone spurs.
• Frozen shoulder.
• Labrum tears, injuries to the tissue around your shoulder socket.
• Osteoarthritis.
• Rotator cuff tears.
• Rotator cuff tendinitis.
• Shoulder impingement syndrome.
• Shoulder instability, when your shoulder joint becomes loose or dislocated.

How common is shoulder arthroscopy?

Shoulder arthroscopy is the second most common orthopedic surgery after knee arthroscopy. Orthopedic surgery treats joints, bones, muscles, ligaments and tendons.

Rotator cuff surgery is one of the most common types of shoulder arthroscopy.

What happens before arthroscopic shoulder surgery?

Before shoulder arthroscopy, your provider will ask you about your health history. You’ll also need to bring in a complete medication list. You may need to stop taking some of your medications a few days before your surgery.

Your hospital will give you specific instructions, including how long before your surgery to stop eating and drinking.

To check your health before your procedure, you also may need:

• Blood tests.
• A chest X-ray.
• Electrocardiogram.

What happens during shoulder arthroscopy?

Shoulder arthroscopy usually takes less than an hour. During shoulder arthroscopy:

1. You will be in a semi-seated position (beach chair position) or lying on your side.
2. Your surgical team will shave hair (if needed) and clean your skin with an antiseptic solution. They may place your arm in a holding device to make sure it stays still.
3. A healthcare provider may inject fluid into your shoulder. The fluid inflates your shoulder joint, making it easier for the surgeon to see.
4. Your surgeon makes a small hole, usually about the size of a buttonhole, in your shoulder. They insert the tiny camera (arthroscope) into this incision.
5. The camera projects images of your shoulder to a video screen. Your surgeon uses these images to find the problem with your shoulder.
6. Your surgeon makes other small cuts in your shoulder and inserts tiny instruments.
7. Once your surgical team finishes your surgery, they close the incisions. You may have stitches or small bandages, with a large bandage on top.

What happens after shoulder arthroscopy?

Shoulder arthroscopy is an outpatient procedure, meaning you can go home the same day. The entire process usually takes less than an hour.

You’ll need to recover for an hour or two at the hospital after surgery. Your providers will offer pain medication if needed. After that, you’ll need a ride home. It’s best if a family member or friend can spend the night with you.

How painful is shoulder surgery?

Unfortunately, all surgery causes pain. But your hospital’s anesthesia staff focus on keeping you comfortable during surgery. They will discuss options with you.

During surgery, shoulder arthroscopy often uses nerve blocks injected into your neck or shoulder. These nerve blocks numb your shoulder and arm. They also help with pain relief after surgery. In some cases, you may have general anesthesia, where you are asleep during your surgery.

Pain during recovery is a natural part of healing. Talk with your healthcare providers about your concerns. They can advise you on how to manage pain as your body heals.

What are the advantages of arthroscopic shoulder surgery?

You may have shoulder arthroscopy instead of open surgery (with a larger incision), depending on your specific concern. Compared to open surgeries, arthroscopic surgeries have less risk of infection and a shorter recovery time. Shoulder arthroscopy also tends to cause less joint stiffness and pain than open surgeries.

What are the risks or complications of shoulder arthroscopy?

Shoulder arthroscopy is generally very safe. There is a small risk that you may experience:

• Blood clots.
• Damage to blood vessels or nerves.
• Excessive bleeding or swelling.
• Infection.

What is the recovery time after shoulder surgery?

Your shoulder joint will take weeks to months to completely heal after shoulder arthroscopy. You may notice pain and swelling for at least several weeks.

Ice and pain medication can help with pain relief. You can also try sleeping propped up in a chair or bed for a few days after your surgery. Your surgeon may recommend a sling to protect your shoulder.

A rehabilitation plan includes gentle exercise and physical therapy. It can increase your shoulder movement and strength. Your healthcare provider will give you a rehab plan that suits your specific shoulder surgery.

When can I go back to work/school/drive/eat?

When you can return to your everyday life depends on the complexity of your surgery. If you’ve had a minor procedure, you may be able to return to work or school in a few days. You’ll need longer to recover from more major procedures. Your healthcare provider will offer guidance suitable for your recovery.

When should I see my healthcare provider?

Talk to your healthcare provider if you have any of these symptoms after your surgery:

• Fever.
• Pain that medication doesn’t help.
• Discolored or smelly fluid around the wound.
• Tingling or numbness.
• Increased swelling.

A note from Cleveland Clinic

Shoulder arthroscopy is a minimally invasive surgery to treat shoulder problems, including shoulder impingement and rotator cuff tears. The procedure usually takes less than an hour. Many people can go back to work or school in a few days. For more complex surgeries, recovery may take longer. A rehabilitation plan, which usually includes exercise and physical therapy, can help you heal faster.