On average, arthroscopic shoulder surgery takes between 30 to 90 minutes to complete.
The procedure is usually performed with the patient under general anaesthesia, meaning they are given medication that puts them into a deep, dreamless sleep. However, in some cases, it can also be done under a local anaesthetic that numbs the shoulder area with a sedative that keeps the patient relaxed throughout the procedure.
Types of shoulder arthroscopy incisions
Arthroscopy is different from other types of surgery because only very small incisions are needed to perform the procedure.
There are usually 2 or 3 incisions and they are usually very small, reaching only one or two centimetres long at the largest.
Generally, one is placed on the back and another on the front, and a third may be placed on the side of the shoulder.
The surgeon will discuss the placement of the incisions well before the day of the surgery.
Shoulder arthroscopy procedure
Once the incisions are made on the shoulder, the surgeon inserts an instrument that fills the shoulder cavity with sterile water. Filling the shoulder with water not only creates room for the arthroscopic tools to move, but it also helps the camera better visibility.
When filled with water, the arthroscope camera and tools are inserted into the shoulder.
Investigative arthroscopic shoulder surgery
For investigative arthroscopic shoulder surgery, the surgeon examines the shoulder to diagnose or investigate any underlying issues.
When they are happy with their investigation or diagnosis, they remove the fluid and tools from the shoulder.
The incisions are closed, and the surgery is over.
Reparative arthroscopic shoulder surgery
The procedure for reparative shoulder arthroscopy is more complex than an investigative procedure.
When the incisions are made and the shoulder is filled with sterile fluid, the surgeon uses arthroscopic tools to repair a variety of shoulder issues.
The most common problems addressed via shoulder arthroscopy include:
- Repair of ligaments or rotator cuff
- Cartilage repair, including the labrum
- Removal of loose cartilage or labrum
- Arthritis treatment, including removal of bone spurs
- Subacromial decompression means shaving down the acromion bone
The diagram below shows the anatomy of the shoulder, including the areas commonly treated by arthroscopic shoulder surgery.
The procedure for each of these problems is slightly different, though most involve either removing tissue, repairing tissue with sutures or smoothing bone.
The surgeon will fully explain what will be done during the procedure well before the day of the surgery.
When the surgeon is done with the treatment, they remove the arthroscopic tools and drain the shoulder of fluid and any debris.
The incisions are then closed, and the surgery is done
Most patients can go home the same day as their arthroscopic shoulder surgery, no matter if it was investigative or reparative.
Physiotherapy and aftercare
Some patients who have arthroscopic shoulder surgery are advised to wear a sling for several days after surgery. This is to protect the shoulder as it heals.
Physiotherapy is also an essential part of healing from orthopaedic surgery, including shoulder arthroscopy. The surgeon and physiotherapist design a physiotherapy plan for each patient to meet their specific needs.
It is vital to the shoulder's future strength and range of motion to follow the physiotherapy plan exactly.
