Shoulder arthroscopy
Valeria Dahm is a freelance writer in the medical department. She studied medicine at the Technical University of Munich. It is particularly important to her to give the curious reader an insight into the exciting subject area of medicine and at the same time to maintain the content.
More about the experts All content is checked by medical journalists.The medical assessment of the inner shoulder joint with an optical probe (arthroscope) is called shoulder arthroscopy or shoulder mirroring. Operations can also be performed in this way. Shoulder arthroscopy is performed under either general or regional anesthesia. Read everything about shoulder arthroscopy, when and how it is done and what risks it entails.
What is a shoulder arthroscopy?
In shoulder arthroscopy, the individual structures of the shoulder joint such as muscles, ligaments and cartilage are examined with the help of an arthroscope. This is a thin tube with a video camera at the end. The doctor inserts the arthroscope into the joint through a small incision and can treat damage and injuries arthroscopically in the same session.
When do you do a shoulder arthroscopy?
Shoulder arthroscopy is primarily used to clarify complaints of the shoulder joint and to examine and, if necessary, treat joint injuries. The most common reasons are:
- degenerative changes (joint wear) such as osteoarthritis
- inflammatory changes
- Injuries or changes caused by an accident (traumatic)
If the doctor determines during shoulder arthroscopy that an operation is necessary, it can often be performed in the same session. Common operations are:
- Fixation of torn muscle tendons, e.g. of the biceps
- Removal of lime deposits from a so-called lime shoulder
- Reconstruction of the muscles of the shoulder (so-called rotator cuff)
- Tightening of the capsule and stabilization in the case of frequent shoulder dislocation
- Removal of abnormally changed joint parts, e.g. in the case of osteoarthritis
What do you do with a shoulder arthroscopy?
As with any arthroscopy, prior to the actual shoulder arthroscopy, the patient's medical history is asked about, the risks and benefits of the procedure are explained, a blood test is carried out and an anticoagulant drug (heparin) is administered so that no blood clots form in the veins during and after the procedure.
Shoulder arthroscopy is usually performed under general anesthesia. But a spatially limited so-called regional anesthesia is also possible. For this purpose, a local anesthetic is injected into the nerve plexus, in which the nerve pathways for the shoulder joint and arm run.
The skin of the operating area is depilated and carefully disinfected. The surgeon brings the arthroscope into the shoulder joint through a small incision and fills it with a sterile liquid or carbon dioxide so that he has more space and thus a better view of the joint structures and the surrounding tissue.
An additional light source and a rinsing and suction device facilitate the examination. The camera transmits the images to a monitor in real time. This has the advantage that the surgeon can move the shoulder joint and thus examine it dynamically. If an operation is necessary, small scissors, burrs and other instruments are inserted through additional incisions. This technique is also called minimally invasive surgery (MIC).
In contrast to an operation on an open joint, the MIS is less stressful and then less painful and the healing process is usually faster. Finally, the arthroscope and instruments are removed and the wounds carefully sutured. A sterile dressing protects the wound from infection.
What are the risks of shoulder arthroscopy?
Shoulder arthroscopy is a relatively uncomplicated examination. In rare cases, the arthroscope or other instruments damage the joint itself or surrounding structures such as muscles or ligaments. In addition, vessels and nerves can be injured. As with any invasive procedure, shoulder arthroscopy harbors typical surgical risks such as blood clots in the veins (thrombosis), intolerance to anesthetics or infection of the wound or joint. In addition, bruises (bruises) and bleeding may occur.
What do I have to consider after a shoulder arthroscopy?
In particular after a shoulder arthroscopy under general anesthesia, or if drains have been temporarily inserted into the shoulder joint to prevent bruising, the patient remains in the clinic for a few days after the procedure.
Initially, the joint must be held still, but on the first day after the operation, the patient begins with physiotherapy under supervision. In order to restore the full function of the shoulder joint, regular and frequent training is required after shoulder arthroscopy.
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