Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint. The benefits of arthroscopy involve smaller incisions, faster healing, a more rapid recovery, and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.
Benefits of the surgery include:
- Minimally invasive
- Small incisions
- Quicker recovery
We Specialize in the Following Procedures & Treatments
Rotator Cuff Repair
The rotator cuff is collection of 4 muscles that help lift and rotate the shoulder. Most tears occur over time due to degeneration, but some are acute. You can also have a partial or complete tear, and tear more than one tendon at a time. The most commonly torn tendon is the supraspinatus. Common symptoms of a rotator cuff tear include pain with lifting of the arm, weakness, and pain at night. Physical therapy can be helpful to strengthen other muscles and improve function and pain, but if a tendon has a complete tear, surgery is usually the best option because the tendon will not repair on its own. Surgery is generally arthroscopic, and can usually be performed as an outpatient. Steroid injections are rarely indicated in rotator cuff tears because it can make the tear worse by weakening the tendon.
Shoulder Instability Treatment
The shoulder is the most mobile joint in our body, which means it is also at the most risk for instability. Typically, instability of the shoulder is caused from a traumatic dislocation. This can often be treated with rest and physical therapy, but if the shoulder continues to dislocate afterwards with minimal force, then the instability often needs to be fixed with surgery. The capsule and labrum are repaired and tightened to better stabilize the shoulder. This is typically done arthroscopically and on an outpatient basis.
The labrum is a soft tissue ring which acts as a seal and stabilizer of the shoulder joint. This can become damaged either in an acute injury or trauma (common in overhead athletes), or degenerate over time. Symptoms can include pain particularly with rotational movements, catching, locking, and decreased range of motion. Sometimes with small labral tears, physical therapy, medication, and/or an injection can be helpful. If surgery is required, the labrum can be repaired arthroscopically. In certain cases, the bicep tendon (which attaches to the labrum) will need to be moved off the labrum and to a different location in the shoulder, and this requires a small incision. The surgery is an outpatient procedure.
Sometimes the rotator cuff is not torn, but it can still cause pain. This is often referred to as cuff tendonitis, bursitis, or impingement. This is because part of the rotator cuff lies underneath two bones called the acromion and clavicle. There is a bursa (a sac that provides cushion) between the bones and rotator cuff to protect it, but with repeated overhead motion, the bursa or the rotator cuff can become irritated. This is because these two structures can become “pinched” by the bone when the arm is lifted. In most cases, this can be treated non-operatively with physical therapy, medications, and/or injections. Sometimes surgery is necessary to remove part of the bone to relieve pressure on the underlying structures. This is an arthroscopic and outpatient procedure.
Pre-Op & Post-Op Course
Most procedures are outpatient procedures. A clearance may or may not be needed based on your medical history. If one is required, this may be done by you PCP, and we will provide you with what tests are necessary. This must be done within 28 days prior to your surgery date.
We recommend stopping use of all anti-inflammatory, fish oil supplements, and other blood thinning medications one week prior to surgery. Your clearing doctor will make recommendations regarding other prescription medications.
Most shoulder procedures are outpatient and you will be going home at the end of the day. The affected arm will be in a sling. For most procedures we recommend beginning Physical Therapy within three to five days. You will be given a packet containing PT prescriptions and home instructions at discharge time.
Typical office follow up is ten to fourteen days after surgery. For surgeries that do not involve a repair a sling is worn for only three days, however, for surgeries that do require a repair a sling is worn for four to six weeks. For surgeries that do not require repair, typically patients may resume full sport activities in six to eight weeks, for surgeries that do require a repair, patients typical resume full sport activities in four to six months.