Shoulder Arthroscopy in Dubai
Shoulder Arthroscopy is a surgical procedure used to repair damaged tissues around or inside the shoulder joint. A tiny camera known as arthroscope is inserted through an incision made to examine the shoulder joint as the repair is being done.
The shoulder arthroscopic procedure is considered advantageous compared to open surgery because there is minimal damage to the tissues during the procedure, and the incisions made are quite small, hence a shorter healing period and minimal stay in the hospital.
An Overview of the Shoulder
The shoulder contains various bones, which include:
- The collarbone also known as the clavicle
- Shoulder blade also known as Scapula
- Humerus bone located in the upper arm
In addition to the bones mentioned above, there are other components that make up the shoulder. These are:
The ball and socket: Ball is the head of the humerus bone which fits into the rounded socket of the scapula. Articular cartilage is a greasy tissue that covers the surface of the ball and socket to prevent friction.
The socket has a ring formed on it known as the labrum cartilage which helps in the stability of the joint motion and the cushioning of the joint.
Rotator cuff: These are tendons that surround the shoulder capsule and assist the arm bone to remain centered in the socket.
Shoulder capsule: This is formed by ligaments at the joint of the shoulder which is then lined by a thick membrane known as the synovium. The synovium produces a fluid called synovial fluid which helps in lubricating the joint.
Bursa: This is a lubricating sac found between the acromion bone (top shoulder bone) and the rotator cuff, which helps in smoothening the movement of the rotator cuff.
Indications for Shoulder Arthroscopy
- Labral tears such as SLAP (superior labrum from anterior to posterior) that cause shoulder instability. This instability occurs when one of the tendons of the biceps muscles slips on the labrum due to the shallowness of the shoulder socket.
- Impingement syndrome (shoulder bursitis) which is caused by inflammation of the bursa.
- Biceps tendonitis whereby the biceps tendons are inflamed leading to pain due to impingement syndrome and tearing of the rotator cuff.
- Tearing of the rotator cuff which leads to difficulty in lifting movements of the shoulder. The tendons also end up getting injured.
- Acromioclavicular joint (AC joint) caused by arthritis.
- Frozen shoulder (adhesive capsulitis) – This occurs when the shoulder joint’s motion becomes stiff and painful, leading to the inability to move the shoulder due to the formation of adhesions (thick bands of tissues) and the reduction of synovial fluid in the joint.
Techniques Involved in Shoulder Arthroscopy
During a shoulder arthroscopy procedure, the arthroscope is inserted through small incisions into the shoulder to examine the bones and the tissues around the joint. The arthroscope has a camera that projects visuals of the target areas on a screen. Other incisions are made through which the damaged tissues are removed and/or repaired. This procedure is performed under light general anesthesia together with a nerve block whereby the shoulder and arm are numbed during and a short while after the procedure.
- In repairing of the rotator cuff, the tendon edges are pulled together and attached with small sutures(anchors) to the bone. The sutures are usually made of plastic or metal and are not necessarily removed after the procedure. Rotator cuff tear can be treated with physical therapy, anti-inflammatory medications, cortisone injections or surgery.
- Repairing of shoulder bursitis or impingement syndrome is done by removing the damaged tissues from the joint. The ligament known as coracoacromial can also be removed, and an overgrown acromion bone which causes the impingement resulting in inflammation is also shaved.
- Labral tears such as SLAP and Bankart tears are repaired by attaching the ligaments.
- Frozen shoulder usually requires physical therapy and pain relief. However, if it worsens surgery may be recommended. The surgical procedure used for treating a frozen shoulder is known as arthroscopic capsular release.
- For affected AC joint arthritis, the damaged collarbone or clavicle is removed.
When the repair is complete the incisions are sutured, and the wound is covered with a dressing.
Possible Complications of a Shoulder Arthroscopy
Just like any other surgical procedure, there are some risks involved in shoulder arthroscopy, but they are minor and can be resolved. These risks include:
- Blood clotting
- Excessive bleeding
- Damage to the nerves or the blood vessels
Recovery After Shoulder Arthroscopy
After a shoulder arthroscopy procedure, the patient can stay in a recovery room for up to two hours so that the wound can be monitored as medication is administered for pain relief. A sling is also provided to support the shoulder.
For a frozen shoulder the recovery is achieved through stretching and physiotherapy but if surgery is involved the motion is regained more slowly, which can be after few weeks or even months.
Cold compresses and pain medication such as non-steroidal anti-inflammatory drugs are recommended to relieve pain and swelling. The position which helps the shoulder in healing fast would be a propped-up bed and sitting on a reclined chair. The patient should avoid lying flat as it may pull the shoulder and cause discomfort. Direct contact of the wound with water should be avoided for faster healing.
Exercise and physiotherapy are recommended for better rehabilitation of the motion and shoulder strength.
Our board-certified orthopedic surgeons at King’s have extensive knowledge of the full range of shoulder disorders and will help you find the ideal medical solution for your condition. You can get in touch by filling in the form below.
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