Arthroscopy of the Shoulder: Diagnosis and Therapy

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Loyola Medicine's Guide to Shoulder Surgery Recovery

Shoulder arthroscopy is a surgical procedure often performed for minimally invasive treatment of a number of different conditions. Shoulder arthroscopy is often performed for treatment of rotator cuff tears , labral tears , and shoulder bursitis. While shoulder arthroscopy is considered a very safe surgical procedure, there are possible complications that should be considered before undergoing surgery for treatment of your condition.

Patients should be aware of the possible complications, and the likelihood of these complications occurring.

Arthroscopic Shoulder Surgery / Shoulder Arthroscopy Overview, Benefits & Risks

Infection is a serious concern whenever having surgery, whether a major surgical procedure or a minor treatment. Bacteria are present on our skin and in the environment, and even with great caution, there is a chance of developing an infection anytime you have surgery. Shoulder surgeries are prone to developing common skin bacterial infections such as Staph and Strep --the most common types of surgical infections. In addition, a less common bacteria called Propionibacterium acnes is often associated with shoulder infections. There are steps that you can take to help prevent surgical infections.

Treatment of infections may require additional surgical procedures and long-term antibiotics, so it is worthwhile for patients to take these steps to help prevent chances of infection. Nerve injury is uncommon, but with the number of major nerves that surround the shoulder joint, this is a possible complication of surgery. When work is required at the bottom of the shoulder the inferior capsule or labrum there is a particular concern of injury to the nerves.

Nerves can either be injured by instruments working inside the shoulder joint, or by inserting the instruments too close to nerves that surround the shoulder joint. One of the most common problems after shoulder surgery is stiffness of the shoulder joint. For some surgical procedures, a period of time of immobilization is necessary to allow for adequate healing.

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However, immobilization of the joint can also cause patients to develop a condition called a frozen shoulder. Patients who develop a frozen shoulder have excessive scar tissue form in the shoulder joint capsule, the tissue that surrounds the ball-and-socket shoulder joint. Frozen shoulder is generally treated with aggressive therapy and sometimes a cortisone injection.

Many cases of frozen shoulder take months or longer to resolve.

Shoulder Surgical Procedures

Chondrolysis is a rare but potentially serious complication of shoulder arthroscopy. Chondrolysis causes damage to the cartilage of the joint surface and can lead to early progression of arthritis of the joint. This is especially problematic for young patients who develop this condition after treatment of an athletic injury.

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  • In some cases, the artificial shoulder joint may replace only the head of the humerus bone in a procedure called stemmed hemiarthroplasty. Resurfacing hemiarthroplasty involves replacing the joint surface of the humeral head with a cap prosthesis. This surgical option often appeals to patients with arthritic shoulder and greater risk of bone loss.

    If needed in the future, resurfaced shoulder joints more easily convert to total shoulder replacement. For shoulder patients suffering from torn rotator cuffs, severe arm weakness, cuff tear arthroplasty, severe arthritis, or other problems, reverse total shoulder replacement provides yet another effective shoulder treatment option. In these cases, the socket and metal ball are reversed to that the ball is fused to the shoulder bone and a plastic socket is installed on the upper arm bone. Some bones of the upper arm break apart, leaving residue behind.

    This repositioning shoulder surgery clears out bone fragments and sets the broken arm with a metal plate.

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    • Similarly, a broken collarbone may shift when fractured. Orthopedic shoulder surgery encourages healing with surgical clavicle realignment using plates and screws or pins, which require smaller incisions. A broken scapula or shoulder blade is infrequent, but can occur in traumatic instances such as car or motorcycle accidents. Different sections of the scapula may be fractured, the bone may shift, and impingement syndrome may also occur.

      These conditions sometimes require orthopedic surgery to install plates and screws while the fracture heals.

      New approaches for frozen shoulder treatment

      An advanced orthopedic surgery method called arthroscopy offers minimally invasive surgery for various shoulder conditions including torn rotator cuff, bone spurs, soft tissue tears, osteoarthritis, loose shoulder, and Bankart lesion. This minimally shoulder surgery invasive can be done on an outpatient basis. The orthopedic surgeon places a camera called an arthroscope directly into a damaged area such as the shoulder joint, using the camera to guide miniature surgical instruments to complete orthopedic repairs.

      In the case of loose shoulder arthroscopy, a radiofrequency probe heats and stimulates the tissue capsule around the shoulder joint.


      Capsular plication causes the tissue to contract, effectively tightening the shoulder joint. For Bankart lesions, arthroscopic shoulder surgery reattaches the labrum, a thick band of cartilage attached to the glenoid bone of the shoulder.

      source The Bankart procedure aims to counteract the effects of a dislocated shoulder , stabilizing the position of the shoulder joint in the socket.