Shoulder arthroscopy allows direct inspection of the shoulder joint and the surrounding structures.
Shoulder arthroscopy is performed in a sterile theatre setting. The patient undergoes a general anaesthetic. Intravenous antibiotics are administered to reduce the risk of infection. There is nevertheless still approximately a 1% chance of developing infection.
The patient is positioned in a beach chair position once they are asleep. This allows access to both the front and back of the shoulder.
The whole arm and shoulder girdle region is prepped with an alcoholic Chlorhexidine skin cleaner. A small incision is made to the back of the shoulder to allow the camera to be inserted into the joint. The space above the rotator cuff tendons is first examined. In cases of bursitis or impingement, the inflamed tissue can be removed from this region.
Separate portal sites are inserted from the side of the shoulder or the front of the shoulder to allow instruments to be passed into the joint.
The shoulder joint itself is then examined. This allows assessment of the cartilage on the joint surface and also inspection of the tendons in that region. The rotator cuff tendons can be inspected from within the shoulder joint.
The shoulder joint is distended with fluid during the procedure. This allows easier access to the joint and visualisation.
The wounds are closed with simple dissolving stitches. Local anaesthetic is usually injected around the wounds for post-operative comfort. Recovery will depend on the extent of intervention has been performed at the time of the arthroscopy. Following surgery, the shoulder region and upper arm may be quite swollen.
Whilst MRI scans can provide a lot of information with regards to pathology within the shoulder joint, shoulder arthroscopy allows direct visualisation of the joint and potential treatment at the time of surgery.