Shoulder Arthroscopy In Gurgaon, Delhi-NCR, India

What is shoulder arthroscopy?

When non-surgical measures such as rest, physical therapy, medication, or injections have not been successful in relieving shoulder pain, shoulder arthroscopy is frequently advised. This minimally invasive technique is frequently used to fix labral tears, shoulder instability, bone spurs, and torn rotator cuffs. It is also successful at treating frozen shoulder and biceps tendon injuries, as well as removing inflamed tissue that causes pain and limits movement.

The surgery can be particularly useful for diagnosis and treatment because it allows surgeons to see a clear image of your shoulder joint with a little camera. With minimal damage to the surrounding healthy tissue, small incisions allow surgeons to treat a variety of shoulder diseases, remove loose fragments, and repair damaged tissue. This procedure often results in a quicker recovery and less postoperative pain than traditional open surgery. 

Small incisions made during arthroscopy often result in a quicker recovery for patients. Most patients experience less discomfort following surgery, recuperate faster, and can typically return home the same day. In addition, a decreased risk of problems than with standard open surgery. 

Anatomy of the shoulder joint

Your shoulder is the most movable joint in your body, but it's also quite complex. Think of it as a carefully designed machine made up of three main bones: your upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). These bones work together to form a joint, similar to a golf ball sitting on a tee, where the round head of your upper arm bone fits into a shallow cup in your shoulder blade.

Key Parts of Your Shoulder:

1. Ball-on-a-T Joint: The round head of your upper arm bone fits into a socket in your shoulder blade, covered with smooth cartilage for easy movement.

2. Labrum: A tough, rubbery rim around the socket that acts like a gasket, adding stability and cushioning to the joint.

3. Joint Capsule: Strong bands of tissue (ligaments) that wrap around the joint like a sleeve, holding everything together.

4. Rotator Cuff: Four tendons that surround the joint, working together to keep your arm centered and stable in the socket.

5. Synovium: A special tissue that produces fluid to lubricate the joint, helping everything move smoothly.

6. Bursa: A small, fluid-filled sac that acts like a cushion between the rotator cuff and shoulder bones.

7. Two Working Joints: The main glenohumeral joint and the acromioclavicular joint (where your collarbone meets your shoulder blade).

8. Subacromial Space: An important gap above the rotator cuff that allows for smooth shoulder movement.

Common Shoulder Conditions That Can Be Treated with Arthroscopy

The majority of shoulder issues are caused by injuries, repetitive motions (such as throwing a ball), or simply aging-related wear and tear. The following issues can be resolved with arthroscopic surgery:

• Rotator Cuff Tear

• Calcific Tendonitis of rotator cuff

• Frozen shoulder

• Biceps Tendon related pathologies

• Shoulder Impingement

• Labral Tears leading to instability of the Shoulder

• Shoulder joint inflammation due to osteoarthritis

Note: While many shoulder issues can be resolved with arthroscopy by making small incisions, some conditions, such as total shoulder replacement, still require open surgery. The best course of action for your particular circumstance will be suggested by your surgeon.

Small incisions and specialized tools are used to treat these conditions, resulting in quicker recovery than with open surgery. 

Planning for Shoulder Arthroscopy

Pre-surgery medical evaluation includes:

• Surgeon consultation.

• Preanesthesia checkup by the anesthetist and investigation to be done accordingly 

Before the procedure:

• The majority of healthy patients will have an outpatient procedure.

• Examining and modifying medications.

• Detailed instructions for arrival time.

• Fasting requirements before surgery.

• Hospital contact for procedure details.

Anesthesia Options:

1. Regional Nerve Block

• Numbs shoulder and arm.

• Injected at the neck base or shoulder.

• Provides post-surgery pain control.

• Lasts several hours after surgery.

2. General Anesthesia

• Often combined with the nerve block.

• Complete sedation during the procedure.

• Recommended for patient comfort.

Surgery Duration:

• Most procedures take under 2 hours.

• Time varies based on required repairs.

• The length depends on the findings during surgery.

Note: Final surgery duration and anesthesia choice will be determined by your surgeon based on the specific shoulder condition and planned procedures.

Surgical Procedure for Shoulder Arthroscopy

A shoulder arthroscopy typically takes less than two hours to perform and is a precise, carefully thought-out surgical procedure. For the surgeon to have unhindered access to your shoulder joint during the procedure, proper positioning is crucial. The surgical team adheres to certain protocols to guarantee the procedure's efficacy and safety.

Patient Positioning:

1. Beach Chair Position

• Semi-seated, similar to the reclining chair.

• Used for certain types of repairs.

• Provides a natural angle for many shoulder procedures.

2. Lateral Decubitus Position

• The patient lies on the side.

• Position chosen based on procedure type.

• Allows good access to joint space.

To guarantee a sterile operating environment, the surgical team starts a comprehensive preparation procedure as soon as the patient is in the correct position. Cleaning the skin, covering the area appropriately, and ensuring the arm remains stable and secure during the procedure are all part of this. 

Pre-Surgery Preparation:

1. Hair removal if needed.

2. Antiseptic solution application.

3. Sterile draping.

4. Arm placement in holding device.

5. Positioning for optimal surgical access.

Creating clear visibility inside the joint is the first of several precise steps in the actual surgical procedure. Small, strategic incisions are then made to perform the necessary repairs. The surgeon makes use of specialized tools made especially for arthroscopic operations. 

Surgical Steps:

1. Joint Inflation

• Fluid injection into the shoulder joint.

• Creates clear viewing space.

• Helps control bleeding.

2. Arthroscope Insertion

• A keyhole incision is made.

• Arthroscope inserted through incision.

• Camera images are displayed on a video screen.

• Allows identification of damage.

3. Treatment Procedure

• Additional small incisions are made.

• Specialized instruments are inserted.

• Tools used for:

• Ablating

• Coagulating

• Shaving

• Cutting

• Grasping

• Suture passing

• Knot tying

• Absorbable Bone anchors are used when needed.

4. Closure

• Incisions are closed with stitches or sterile strips.

• A soft bandage is applied.

• Typically 3-5 keyhole incisions are used.

Note: While these are the standard steps for shoulder arthroscopy, the specific details may vary depending on your particular shoulder condition and your surgeon's preferred techniques. The length of the procedure will depend on what repairs need to be made once the surgeon can see inside your shoulder joint.

Risks and Complications of Shoulder Arthroscopy

Although shoulder arthroscopy is regarded as one of the safest and most successful surgical procedures, it's crucial to realize that risks and complications are possible with any surgery. Although the majority of complications are uncommon and can be successfully treated if detected early, patients should be informed of these risks prior to having surgery. 

Although very rare, potential risks and complications:

1. Bleeding

2. Transient numbness

3. Infection

4. Swelling

5. Stiffness

6. Anesthesia Reactions

Recovery from Shoulder Arthroscopy

The majority of patients recover within 6 weeks following shoulder arthroscopy. The patients are encouraged to do passive movements and exercises from the very next day of surgery along with the use of a sling and ice packs four times a day along with prescribed medications. 

The patients can resume their desk job within a week or two from the day of the procedure. Physical job may be resumed within 6 to 8 weeks

Your shoulder will gradually regain its strength and range of motion with consistent physical therapy and adherence to your doctor's instructions. After surgery, full recovery usually takes three to six months, during which time one can resume heavy labor or sports. 

Why Choose Artemis Hospital for Shoulder Arthroscopy?

1. JCI-Accredited Facility: Meets worldwide safety and care standards, equipped with modern operating theaters and advanced arthroscopic equipment.

2. Experienced Team: Skilled orthopedic surgeons and specialists with 10+ years of experience in shoulder arthroscopy.

3. Modern Facilities: State-of-the-art arthroscopic equipment, high-tech operating rooms with strict sterile protocols.

4. Support Services: Comprehensive rehabilitation with a dedicated physical therapy team, personalized recovery programs, and regular follow-up care.

Reviewed By Dr. Mohd Irfan Banday
Consultant - Orthopaedics
Artemis Hospitals

Frequently Asked Questions

How long will I be in the hospital after shoulder arthroscopy? 

Most patients go home on the same day as the surgery. You'll typically spend 2-3 hours in recovery before being discharged.

What type of anesthesia will be used? 

You may receive either general anesthesia (fully asleep) or regional anesthesia (nerve block) with light sedation. Your surgeon will discuss which option is best for you.

When can I return to normal activities? 

Light activities and desk work can resume in 1-2 weeks. Driving usually starts after 6 weeks. Return to sports takes 3-6 months.

Why would I need shoulder arthroscopy? 

It's recommended for rotator cuff tears, shoulder instability, labral tears, and other conditions that haven't improved with non-surgical treatment.

What are the potential risks? 

While generally safe, risks include infection, bleeding, blood clots, and nerve injury. Your surgeon takes precautions to minimize these risks.

How do I prepare for surgery? 

Stop certain medications as directed, follow fasting instructions, arrange for someone to drive you home, and prepare your home for recovery.

How long does the procedure take? 

Most shoulder arthroscopies take 30-90 minutes, depending on what repairs are needed. Total time in the surgical center is about 4-5 hours.

What can I expect after surgery? 

You'll have some pain and swelling, so wear a sling, and start physical therapy as directed. Full recovery takes 3-6 months.

When can I start exercising? 

Light exercises start within a few days. Strengthening begins after 6 weeks. Full sports activities resume in 3-6 months with your surgeon's approval.

How big will the incision scars be? 

Most incisions are just 5-10 millimeters long, about the size of a buttonhole. They typically fade well over time.