Closed surgical technique in which small incisions are made around the shoulder and a camera is used to visualize and repair problems with the rotator cuff, labrum and intra-articular structures.
Indication
- Rotator cuff (shoulder muscle-tendon) tear
- Subacromial impingement syndrome unresponsive to medication and physical therapy
- SLAP or Bankart lesions (labrum tears)
- Recurrent shoulder dislocation and joint instability
- Frozen shoulder (adhesive capsulitis) — prolonged cases
- Acromioclavicular joint osteoarthritis or impingement
- Loose intra-articular bodies, calcific deposits (calcific tendinitis) or cartilage lesions
Preparation
- Pre-operative MRI or MR arthrography to assess tears and lesions
- Anesthesia consultation, blood tests and ECG
- Stopping blood thinners and certain herbal products with physician approval
- No food or drink for 6-8 hours before the procedure
- Smoking is known to slow healing; stopping 2-4 weeks beforehand is recommended when possible
How it's performed
- General anesthesia is usually combined with a regional (interscalene) block
- The patient is placed in the lateral decubitus or beach-chair position
- Two to four small incisions are made around the shoulder
- The arthroscope and specialized instruments are introduced into the joint
- Depending on findings, the torn tendon is fixed to the bone with suture anchors, bony spurs are shaved and impinging tissues are released
- The joint is irrigated, incisions are closed and the shoulder is placed in a sling
Post-procedure
- Most patients are discharged the same day or after a one-night hospital stay
- A shoulder sling is typically worn for 4-6 weeks (depending on the repair performed)
- Passive range-of-motion exercises in the first weeks, followed by active exercises
- Physical therapy usually continues for 3-6 months
- After rotator cuff repair, full strength and return to sport may take 4-9 months
Risks
- Infection (rare)
- Nerve injury (especially the axillary nerve, rare)
- Vascular injury (very rare)
- Joint stiffness, frozen shoulder
- Re-tear of the tendon repair (higher risk in larger tears)
- Temporary side effects related to anesthesia and the interscalene block
FAQ
How long will I be unable to use my arm after shoulder arthroscopy?
It depends on the procedure. After a simple debridement or impingement surgery, light use may be possible within days. After a rotator cuff repair, 4-6 weeks of sling protection and several months of progressive strengthening are required.
Will I have trouble sleeping after surgery?
Lying on the operated shoulder is difficult in the first weeks. Sleeping on your back or in a semi-upright position with the arm supported by pillows is more comfortable for most patients.
When can I start driving?
Generally once you are out of the sling and shoulder movements are pain-free and controlled, often 4-6 weeks after surgery. The exact timing depends on the repair performed and your physician's approval.
When can I return to sport and heavy lifting?
Low-impact activities can usually be resumed at 6-12 weeks. For heavy lifting, throwing sports and full-contact activities, a 4-9 month timeline is expected; the decision is based on physical therapy results.
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