It is a minimally invasive method of performing surgery of the shoulder joint. The instrument is 4.5 mm diameter arthroscopy which is inserted through a small keyhole made over the skin.
The instrument has a camera and the structures inside the shoulder can be visualised. Another Keyhole is made depending on the surgery and requirement to insert implants and other instruments inside shoulder.
Arthroscopic surgery of shoulder is needed in following cases –
The muscles shown are attached to the shoulder and form a white tendinous structure just before insertion. This is called rotator cuff.
The rotator cuff muscles are responsible for abduction of shoulder primarily.
Any injury to cuff causes weakness in abduction and also internal rotation.
Pain arising of rotator cuff is suspected if you are having shoulder pain which is persistent. Typically, many patients complain of night pain or pain even at rest. The pain is relieved by analgesics. Any traumatic incident involving shoulder may predispose you to have rotator cuff injury.
After any shoulder pain, take rest and avoid any activity involving lifting weight.
Cold fomentation for 5 minutes every couple of hours will help in symptomatic relief.
If the pain persists even after 3-4 days, then you need to visit a doctor for examination.
Also, if there is significant pain with weakness in shoulder abduction, then you need to visit a doctor.
After the doctor examines your shoulder, he could suggest you if you need any investigations like MRI.
There are few indications of MRI –
Do Not do the following –
Surgery is usually done as outpatient. You will have to arrive in morning on the day of surgery after prior fixed appointment. If you are young, fit and healthy and have adequate pain relief after surgery, you can be discharged home after few hours of surgery. Sometimes, 1-overnight stay at hospital is necessary for adequate pain relief. If you are comfortable, pain is well controlled with painkillers and able to move around on your own the next day, then in that case, you are fit to be discharged home.
General anaesthesia is given for the procedure. The Position of patient is either in Beach Chair sitting position during surgery or supine with lateral decubitus position.
Follow up is needed at a weeks’ time for keyhole wound check and dressing.
You will need to take rest for at least 6 weeks. After 6 weeks we usually start gradual physiotherapy which involves active assisted mobilisation.
The protocol for physiotherapy and rehabilitation will change depending on the nature of surgery.
If the surgery is for frozen shoulder, then immediate post-operative physiotherapy with mobilisation is needed to prevent stiffness.
The post-operative rehabilitation and physiotherapy is an integral part of treatment after the surgery. We have an experienced Team of Physiotherapist who will guide you in gradual mobilisation and strengthening exercises of shoulder.
Usually, full return to sports activity is possible after 6 months.
Like any surgery, there are some routine complications which are same for any surgical procedure and some special complications which are specific for procedure.
Overall, the procedures are routinely performed and the complication are minor and treatable. These include infection, bleeding, need for revision surgery for re-rupture or tear, blood clots, injury to blood vessels and nerves.