What is shoulder arthroscopic surgery?

Shoulder arthroscopy is a type of surgery. It lets a doctor repair shoulder problems without making a large cut (incision).

To do this surgery, the doctor puts a lighted tube through small incisions in your shoulder. The tube is called an arthroscope or scope. Next, the doctor puts some surgical tools in the scope to help make any repairs. The incisions will leave scars that usually fade with time.

This type of surgery is used to treat many shoulder problems.

Osteoarthritis.

This happens when your cartilage breaks down. Cartilage is the hard, thick tissue that cushions the joints. For this problem, the doctor shaves and smooths rough surfaces on the shoulder joint.

Loose body.

This is a loose piece of bone or cartilage. It's often caused by an injury. The doctor may put the loose piece back in place. Sometimes the piece is removed.

Impingement syndrome.

This happens when shoulder tissue starts to swell and rub against a bone. This can occur in the tendons of the rotator cuff. Or it may happen in the tendons that connect the bicep to the shoulder. It can also occur in the bursa, the sac between the rotator cuff and the top of the shoulder blade. To fix this problem, your doctor removes the bursa and part of the bone from the point of your shoulder. This increases the space in the shoulder area. In a few weeks, the bursa re-forms.

Most people go home on the day of the surgery. When you can go back to work or your usual activities depends on your shoulder problem. You will probably need about 6 weeks or longer to recover.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. You may be more comfortable if you sleep in a reclining chair. To make your arm and shoulder feel better, keep a thin pillow under the back of your arm while you are lying down.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• For 2 to 3 weeks, avoid lifting anything heavier than a plate or a glass. You need to give your shoulder time to heal.
• Your arm may be in a sling. You may need to use the sling for a few days to a few weeks. Your doctor will advise you on how long to wear the sling.
• You may take the sling off when you dress or wash.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids, unless your doctor tells you not to.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have a dressing over your incision, keep it clean and dry. You may remove it 2 to 3 days after the surgery.
• If your incision is open to the air, keep the area clean and dry.
• If you have strips of tape on the incision, leave the tape on for a week or until it falls off.

Exercise

• You may need rehabilitation. This is a series of exercises you do after your surgery. Rehab helps you get back your shoulder's range of motion and strength. You will work with your doctor and physical therapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you.

Ice

• To reduce swelling and pain, put ice or a cold pack on your shoulder for 10 to 20 minutes at a time. Do this every 1 to 2 hours. Put a thin cloth between the ice and your skin. If your doctor recommended cold therapy using a portable machine, follow the directions that came with the machine.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Arthroscopy is a way to find problems and do surgery inside a joint without making a large cut (incision). Your doctor put a lighted tube with a tiny camera—called an arthroscope, or scope—and surgical tools through small incisions in your shoulder.

Your arm may be in a sling. You will feel tired for several days. Your shoulder will be swollen. And you may notice that your skin is a different color near the cuts the doctor made (incisions). Your hand and arm may also be swollen. This is normal and will go away in a few days. Depending on the medicine you had during the surgery, your entire arm may feel numb or like you can't move it. This goes away in 12 to 24 hours.

How soon you can go back to work or your usual routine will depend on your shoulder problem. Most people need 6 weeks or longer to recover. How much time you need depends on the surgery that was done. You may have to limit your activity until your shoulder strength and range of motion are back to normal. You may also be in a rehabilitation program (rehab).

If you have a desk job, you may be able to go back to work a few days after the surgery. If you lift things at work, it may take months before you can go back.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You may be asleep or have medicine to relax you. And if you're awake, the area will be numbed. It's often numbed even if you are asleep.
• The surgery will take about 1 to 2 hours. It depends on what type of shoulder problem you have.