What is arthroscopic shoulder surgery?

Shoulder arthroscopy is a minimally invasive surgical method of treating various pathologies within the shoulder. As a result, smaller incisions are made over the shoulder joint, and an arthroscope, containing a light and camera attached at one end, is inserted through one of the tiny cuts.

Arthroscopic surgery can be performed to treat the following shoulder conditions:

• A rotator cuff tear is a component made up of a collection of tendons and muscles that surround the shoulder joint. The rotator cuff ensures not only movement but also the balancing of forces to keep the humeral head in place for adequate function.
• Shoulder impingement is one of the most common reasons for shoulder pain. Shoulder impingement occurs when the rotator cuff tendons are caught due to decreased space within the subacromial space. This typically produces pain with overhead activity when the shoulder hits against or gets caught on surrounding tissue and bone when raising the arm.
• Acromioclavicular joint degenerative disease can cause pain with cross-over shoulder movement and impair the range of movement. Arthroscopic excision alleviates the pain driver.

What arthroscopic shoulder surgeries does Dr Grey perform?

Dr Grey performs the following minimally invasive shoulder surgeries:

• Bankart repair
  is a surgery to repair the soft tissue restrained that has been injured due to repetitive shoulder dislocations. The surgery involves restoring the stabilizing effect from the labrum onto the glenoid rim.
• Subacromial decompression
  helps treat a painful condition referred to as “shoulder impingement”, which results in discomfort when elevating the arm. This procedure is commonly done through small incisions made over the shoulder by means of shoulder arthroscopy. Subacromial decompression aims to ensure enough space beneath the acromion so it does not rub against the tendons, and great care is taken to smooth out the rough surface of the undersurface of the acromion.
• ACJ (Acromioclavicular joint) excision
  is a procedure done by means of keyhole surgery. Dr Grey clears the affected soft tissue inside the joint and uses a high-speed burr to resect a specific amount of bone from the end of the collarbone and acromion. This surgery prevents pain because of friction between the degenerative surfaces.
• Biceps tenodesis
  is a procedure which entails rerouting the biceps tendon from the intra-articular labrum to the bicipital grove of the humerus.
• Capsulotomy
  involves cutting through restricted portions within the joint capsule, which is done by placing small surgical tools through very few tiny incisions made over the shoulder. This procedure is done to improve the restricted range of motion secondary to a thickened and tight capsule.
• Calcific tendonitis debridement
  avoids overexposing the joint through a large cut. Instead, between two to three tiny incisions are made, one of which the arthroscope is inserted through. Dr Grey starts by debriding (cleaning out) the joint by removing affected tissue. He then uses a needle to mark the region where the calcific deposit can be found. Next, he makes a minor incision in the tendon and uses a curette to remove the calcific deposit.
• Rotator cuff repair
  refers to the insertion of an arthroscope through a small cut made above the shoulder. Additional surgical cutting or grasping tools can be placed through the other small cuts. The torn tendon is mobilized and repaired to the bone using bone anchors with sutures through the tendon. At the same, Dr Grey removes bone spurs if they are present within the joint.

How do you perform arthroscopic shoulder surgery?

After adequate preparation of the surgical site, Dr J.P. Grey pumps fluid into the joint to inflate the region. The camera at the tip of the scope then projects images of the inside of the shoulder onto a monitor in Dr Grey's theatre. The images on the screen help determine the cause of the shoulder-related issue and allow Dr Grey to correct the problem using miniature surgical equipment. Other, smaller incisions are made around the shoulder, which allows Dr Grey to place additional surgical tools through these openings. After treating the area, Dr Grey applies small bandages over the tiny incisions and a much larger bandage is placed over the entire region.

You'll need one to two hours to recover thoroughly from the procedure. In the interim, pain medicine can be administered if requested. In addition, it’s best advised that you arrange for a colleague, family friend, or sibling to drive you home because grogginess is to be expected.

FAQ