Other popular names
- Keyhole surgery
- Shoulder scope
Why is it done?
There are many reasons to do this. Sometimes, even after taking a history, examination and carrying out various different investigations the diagnosis is still not clear or the extent of the problem is not apparent. Arthroscopic assessment is therefore undertaken. There are an increasing number of treatments used with the arthroscope. These include treatment of impingement syndrome, rotator cuff repair, treating arthritis of the acromioclavicular joint, stabilization, capsular release for frozen shoulder and nerve releases.
An arthroscopy is not a treatment in itself. It is a diagnostic procedure to identify problems in the shoulder. An MRI scan can also show problems inside the shoulder joint and is occasionally used as an alternative investigation.
Surgery is carried out as a day case procedure under general anaesthetic. A simple look around takes about 15 minutes, but if other procedures need to be performed, it can take longer. Two or three small 3-4mm incisions are made around the shoulder to allow the camera and instruments inside. After the arthroscopy, the wound is stitched or secured using steristrips. Often, the wound is not closed at all. However, the wound usually heals without a problem. A dressing is applied. A sling is worn. You will be advised when to remove the sling.
The example shown above show photos taken through an arthroscope for a normal shoulder joint lining (left) and an inflamed joint lining damaged by frozen shoulder (right)
You can go home soon after the operation. The anaesthetic will wear off after approximately 6 hours. Simple analgesia (pain killers) usually controls the pain and should be started before the anaesthetic has worn off. The dressing is removed soon after the operation. The wound is cleaned and redressed with a simple dressing. The sutures are removed at about 12 days. Any further treatment that the arthroscopy has identified will be discussed when you attend for a follow-up consultation in the clinic about three weeks after the operation.
Return to normal routine
Keep the wound dry until the stitches are taken out or steristrips removed at 12 days.
Return to driving:
The hand needs to have full control of the steering wheel and left hand the gear stick. You are advised to avoid driving for at least 7 days or until the sutures (stitches) are removed. You will be given advice regarding this at the time of your surgery.
Return to work:
Everyone has different work environments. Returning to work will depend on what has been carried out during the operation and the type of work that you do. You will be given advice on your own particular situation.
General risks (less than 1% each):
- Neuroma (nerve pain)
Reflex Sympathetic Dystrophy - RSD (<1% people suffer a reaction to surgery with painful stiff hands, which can occur with any shoulder surgery from a minor procedure to a complex reconstruction).
- Injury to nerves of the forearm and hand