Shoulder Arthroscopy Risks and Recovery

What is Shoulder Arthroscopy?

Shoulder arthroscopy is a minimally invasive procedure performed on the shoulder joint to repair its damaged portions. The surgery takes less than two hours to complete and is less painful than traditional open shoulder surgery. Also, the surgical procedure being minimally invasive, recovery period is reduced. It is not a complex type of surgery and is a common treatment approach to cure severe shoulder pain.

Why is Shoulder Arthroscopy Required?

If you are suffering from immense shoulder pain that does not get cured in spite of medications, injections and non-surgical treatments, then doctor may recommend shoulder arthroscopy. Generally, due to age and injury, shoulder muscles get ripped and that can cause severe pain. Inflammation of shoulder joint may cause stiffness, pain and swelling. There are several reasons why a person becomes a candidate for shoulder arthroscopy surgery. Below mentioned are some of the common reasons which make the doctor recommend you to undergo this surgery:

• Damaged or torn ligaments and cartilage ring (labrum)
• Damaged or torn bicep (muscle located in the front of upper arm) tendons. There are two tendons attached to the bicep muscle. One attaches the bicep muscle to the bones of the shoulder while the other attaches the muscle to radius bone at the elbow. If any of these tendons get broken or torn, surgery is required to fix them.
• Shoulder instability that can be explained as shoulder joint becoming loose and sliding too much or getting dislocated.
• Loose tissue which causes pain and needs to be removed
• Broken or damaged rotator cuff
• Inflammation or bone spur around rotator cuff
• Damaged or inflamed lining of the shoulder joint that may be caused due to rheumatoid arthritis
• Arthritis of clavicle (collarbone)
• If you are experiencing problem to move your shoulder around, it could be because of less space. Hence, surgery could be performed to make more room for shoulder joint to move effectively around.

Pre-operative Preparation

You need to let the doctor know about all the medications you are currently intaking. This includes tablets, supplements, herbs etc. Below mentioned are some points that you need to discuss with your doctor.

During the 2 weeks prior to surgery, following things have to be practiced:

• Doctor may ask you to discontinue blood thinning medicines that make it harder for blood to clot. These medications comprise aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve,Naprosyn) and other medicines.
• Your doctor will tell you the exact medicines which you should discontinue and which to continue till the day of your surgery.
• Inform your doctor if you consume alcohol on regular basis and in what amount.
• Quit smoking if you have been doing it. Smoking has negative effects on body and can delay wound and bone healing.
• If you are suffering from flu, cold, herpes or any other illness, let your doctor know about it.

Apart from above mentioned points, doctor may ask you to undergo routine blood tests to assess your hemoglobin levels and check for abnormal white blood cells count. Over normal limit range count of WBC's, reveal infection. Also, doctor will tell you to take some iron supplements if your hemoglobin level does not fall in normal range. Chest X-ray is also required.

In case you have medical insurance, take care of the legal formalities that you have to do with the insurance company so that they can manage your finances and medical bills. It's better done few days in advance than a day before the surgery since it is a time consuming process and at the last minute, you don't have to worry about your finance.

Day Before Surgery

On the day before surgery, you need to first relax and calm your mind. You are going to undergo a surgery the next day and hence, you need to think positive and not get stressed. Make sure that you make arrangements for blood transfusions so that it can be of help in case the need arises. Have a healthy meal and make sure that you don't eat anything on the night prior to the day of surgery because for shoulder arthroscopy, fasting is required. If you have to take medications, take them with a sip of water.

Procedure Day

On the day of surgery, doctor will check all your vitals that includes assessing your blood pressure and heart beat, checking your body temperature, etc. If all these things are in proper range, then only the doctor will commence the operation; else it may get delayed depending upon intensity and severity of the issue.

You will have to do all the legal formalities like signing the medical documents prior to the procedure. The patient is required to change into hospital gown which is sterilized in order to minimalize the risk of infection. Also, the place where incision is to be made is cleaned with an antiseptic solution so that the region becomes clear of any bacteria.

Methods/Techniques of Shoulder Arthroscopy

Shoulder arthroscopy surgical technique makes use of arthroscope which is a small, fiber-optic instrument with attached camera and through which interior part of the joint can be evaluated and operated. With the help of camera, images are displayed on video monitor and these images are used as reference for guiding special miniature surgical instruments.

Procedure of shoulder arthroscopy is conducted using the following steps:

• Anesthesiologist will administer general anesthesia before the surgery that will make the patient numb and unconscious during the surgery. The patient may have surgery either lying on one side keeping the the shoulder to be operated exposed or sitting in deckchair position.
• An incision (small cut) or incisions will be made on the shoulder joint through which arthroscope will be inserted. The tiny camera attached to arthroscope will enable the surgeon to view interior of shoulder joint.
• The images will be examined by the surgeon to look out for damaged portions. Then, special instruments are inserted in the incision to repair the damaged portion of the joint. Damaged tissues that restrict shoulder movements and cause pain will be removed.
• The incisions will be closed either with stitches or adhesive strips. Doctor will also wrap dressing and bandage around the shoulder.

If surgeon has to perform open surgery depending upon the extent of damaged portion of the joint, he/she will let you in advance to get your consent and tell you about the risks associated with open shoulder surgery.

Post Procedure

Post shoulder arthroscopy, patient needs to follow all the precautions that doctor has recommended. Since every patient is not same, recovery period for every patient is also not same. It differs from patient to patient and how well you take care of yourself post surgery.

• Wearing a Sling: The patient will probably have to wear a sling in the operated hand for a few days. But, if the surgery involved lot of repair, then you may have to wear sling for a longer time.
• Painkillers: You may experience pain for a few days or a week post surgery. If the pain is intense, then you should consult with your doctor. Your doctor might prescribe you some painkillers to ease out the pain.
• Physiotherapy: Patient can take help of physiotherapist to help with shoulder movements that can aid in regaining strength of shoulder muscles and shoulder joint. Also, physiotherapist will chalk out exercise plan exclusively designed as per your needs and requirements that will reduce recovery period and make it less painful. Ask you doctor if you can return to sports. Putting undue strain on your shoulder muscles in the initial phase of recovery should be refrained from. Gradually, you can increase your shoulder movement. It takes approximately 1 month to 6 months for complete recovery.
• Follow-up: Follow-up appointments should not be missed as they assess your recovery and check whether the outcome of the surgery is fine or not. Also, through these procedures, some surgery risks are also evaluated. If there are any abnormalities felt after the surgery, then in follow-up sessions, patient can get it cleared with their doctor.
  You may have to take several weeks or months off work to rest and recover. However, this varies form person to person depending upon his/her occupation.
  Attention should also be payed towards one's diet. Balanced diet helps in meeting nutritional requirements and that also ensures quick recovery.

Risks And Complications

Every surgery comes with its fair share of risks. Below mentioned are few risks and complications associated with shoulder arthroscopy:

• Anesthetic risks and surgery risks in general include breathing problems, blood clots, infection, bleeding, allergic reactions towards medicines, etc. Also, it's quite normal for the patient to feel uncomfortable for a day after the surgery till the effect of anesthesia completely fades away.
• Risks of shoulder arthroscopy comprise shoulder stiffness, injury to the nerve or blood vessel in or near the shoulder joint, weakness in the joint or inability to move shoulder joint effortlessly. Repaired tissues or parts of the shoulder bones fail to heal and surgery fails to relieve symptoms which prompted patient to undergo shoulder arthroscopy.

Shoulder arthroscopy is a good treatment approach for patients suffering consistently from intense shoulder pain. Also, the procedure is a less invasive one which makes it less painful and shortens recovery period.