Shoulder Arthroscopy

What is a Shoulder Arthroscopy?

Shoulder arthroscopy is surgery that uses a small camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint.

This operation only requires small cuts to insert the instruments. For this reason it is often referred to as ‘key hole surgery’.

Using arthroscopic shoulder surgery, a surgeon can perform a number of procedures, including:

  • Rotator cuff repair.
  • Shoulder stabilisation.
  • Capsular Release.
  • Acromioplasty (Subacromial Decompression).

Also known as

  • shoulder scope
  • key hole surgery

Who is this operation for?

You may benefit from a shoulder arthroscopy surgery, if:

  • Have pain when lifting arms above shoulder height or lying on your side. 
  • Have damaged your rotator cuff.
  • Your shoulder has dislocated multiple times.

What conditions can a shoulder arthroscopy help with?

The following conditions may be helped with a shoulder arthroscopy:

  • Certain types of shoulder instability
  • Rotator cuff tears
  • Bursitis or Impingement syndrome (arthroscopic subacromial decompression)
  • Biceps tendonitis
  • Frozen shoulder

Follow the links to find out more about these conditions

What are the alternatives to surgery

Surgery may be necessary if your symptoms are severe. There are however some alternatives to surgery which may help with the symptoms of your shoulder problem. These include:

  • Pain-relief medications – such as paracetamol.
  • Anti-inflammatory medications – these medications can be harmful if used long term and you should discuss the use of these medications with your doctor before 
  • starting.
    Physiotherapy – exercises to improve muscle strength may help with mobility and reduce pain.
  • Cortisone injection – an injection into the shoulder may help to relieve your pain. This may be short term. 

What are the benefits of a shoulder arthroscopy?

A shoulder arthroscopy is usually a very successful operation and can help to:

  • Reduce pain
  • Improve mobility: You should be able to move your arm more freely after your operation.
  • Improve your quality of life: With less pain and better mobility, you be able to carry out your daily tasks more easily.

Complications 

What are the complications and risks of having a shoulder arthroscopy?

The complication rate following shoulder arthroscopy is very low. However like all surgery, there are risks that need to be considered when deciding to have the operation. 

Side effects

Side effects are symptoms that occur after every operation and are a normal part of the recovery from the operation. The main side effects of shoulder arthroscopy are:

  • A sore shoulder which may last for several weeks after the operation
  • Swelling in the upper arm which will also last for several weeks after the operation

Complications

Complications are uncommon problems that occur during or after the operation. Most people having a shoulder arthroscopy aren’t affected.

The general complications for all operations are:

  • A reaction to the anaesthetic
  • Infection of the wound or joint
  • Excessive blood loss

Specific complications of shoulder arthroscopy are:

  • Shoulder stiffness 
  • Failure of the surgery to relieve symptoms 
  • Injury to nerves: this may leave the shoulder weak or an area of skin over the shoulder numb. This is a very rare complication. 
  • Injury to the cartilage inside the shoulder joint: This may result in pain or instability in the joint. Again, the risk of this occurring is low. 

Before the operation

Preadmission clinic 

Before your operation, you will be seen at the Preadmission clinic to make sure you are fit for the operation and all the necessary tests are performed in preparation for the operation. 

During the visit, you will be seen by a 

  • Doctor 
  • Nurse 
  • Anaesthetist (if necessary) 

Tests 

Tests that may be ordered for you may include: 

  • Shoulder x-ray
  • Shoulder ultrasound
  • Shoulder MRI
  • Blood tests 
  • ECG 

Preparing your skin 

Your skin should not have any infections or irritations before surgery. If either is present, contact your orthopaedic surgeon for a program to improve your skin before surgery. 

Medications 

Our doctors can advise you which medications to stop, and which medications to continue prior to surgery. 

About the Operation 

Admission

Most people are admitted to hospital on the day of their surgery.

Anaesthesia

The anaesthetic team will see you and decide the type of anaesthetic that’s best for you.

The different types of anaesthesia include:

  • General Anaesthetic. This type of anaesthetic puts you asleep during the whole procedure and a machine controls your breathing.
  • Nerve Blocks. This special injection is used to help with your pain after the operation and often used in conjunction with a general anaesthetic.

The Surgery

First, your surgeon will examine your shoulder with the arthroscope. 

Your surgeon will:

  • Insert the arthroscope into your shoulder through a small incision. 
  • Inspect all the tissues of your shoulder joint and the area above the joint
    • cartilage, bones, tendons, and ligaments. 
  • Repair any damaged tissues. 
  • To do this, your surgeon will make 1 to 3 more small incisions and insert other instruments through them. A tear in a muscle, tendon, or cartilage will be fixed. Damaged tissue may need to be removed. 

Your surgeon may do one or more of these procedures during your surgery: 

  • Rotator cuff repair. The edges of the muscles are brought together. The tendon is attached to the bone with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic. They do not need to be removed after surgery. 
  • Surgery for bursitis. Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. Your surgeon will then shave off the under part of the bone causing irritation of the bursae. This under part of the bone is called the acromion. 
  • Surgery for shoulder instability. If you have a torn labrum (the rim of the shoulder joint that is made out of cartilage) your surgeon will repair it. Ligaments that attach to this area will also be repaired.

After the Operation

After the operation, you are cared for in the Theatre Recovery room. You will usually only spend 1-2 hours in the recovery room. 

Most people wake up fully when back in their rooms on the ward. Whilst on the ward, the nurses will take care of your every need. It usually takes a few hours to recover fully from the anaesthetic, and the nurse with regularly check on your recovery.

Most people go home after one night at the hospital. You will normally need to wear a sling after the operation.

Recovery and Rehabilitation 

Rehabilitation

The rehabilitation program varies depending on what was operated on during the arthroscopy.

Your physiotherapist will give you exercises to help to improve the flexibility and strength of the shoulder. It is important to follow the advise of the physio and make sure that you complete the recommended exercises in order to get the best outcome from the operation.

Will I have to wear a sling?

Most people go home with a sling after this operation. If you had a rotator cuff repair or labrum repair you may have to wear a sling for up to 6 weeks after the operation.

If you only had the bursa cleaned up and the bone spur shaved, you may not need a sling after a few days.

Back to work / sport

If you work in an office environment, you should be able to return to work within a week of the operation. 

The time to return to sport or heavy manual work varies depending on what structures were repaired. 

If you had a bursae cleaned up and a spur removed, you should be able to get back to most activities within 4 weeks of the operation. 

If you had a rotator cuff repair or a labrum repair, it may take 3 months to return to most activities. 

F.A.Q.s | Frequently Asked Questions

Are there important things I need to tell my doctor? 

It is important to tell your doctor if you experience any of these symptoms after the procedure: 

  • Redness, swelling or warmth around the incision. 
  • Leakage from the incisions. 
  • Fevers and chills. 
  • Severe shoulder pain not relieved by painkillers. 
  • Weakness in the shoulder or arm 
  • Loss of sensation or pain in the skin overlying the shoulder or forearm