Patient education: Shoulder arthroscopy (The Basics)

What is shoulder arthroscopy? — 

This is a type of "minimally invasive surgery." During shoulder arthroscopy, the doctor looks inside the shoulder joint to see what is causing a problem (figure 1). They can also use special tools to repair or remove tissue in the shoulder.

Minimally invasive surgery lets the doctor make smaller cuts ("incisions") in the skin. They insert long, thin tools through the incisions. One of the tools has a camera (called an "arthroscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery.

Your doctor might suggest surgery if your shoulder problem is getting worse after trying physical therapy and medicines. People who have minimally invasive surgery often have less pain and can return to normal activities sooner than if they had a larger incision.

How do I prepare for shoulder arthroscopy? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Before the procedure, your doctor will do an exam. They might send you to get additional imaging tests, such as an X-ray, CT scan, or MRI. These create pictures of the inside of the body.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – You might need to "fast" before surgery. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure.

●Lowering the risk of infection – You might need to trim (not shave) your body hair. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during shoulder arthroscopy? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure you do not feel pain during the procedure. Types of anesthesia include:

•Local – This uses medicine to numb a small part of your body so you don't feel pain.

•Regional – This blocks pain in 1 area of your body, such as an arm. You might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This makes you unconscious so you can't feel, see, or hear anything during the procedure. You might get a breathing tube to help you breathe.

●You might get medicines to help control pain after the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will make small incisions in the skin over your shoulder. They will put an arthroscope through 1 of the incisions to look at your joint. They will fill your joint with fluid to see inside it. They will put small surgical tools into the other incisions to find and, if possible, fix the problem inside your shoulder.

●The doctor will close your incisions and cover them with clean bandages.

●The procedure usually takes 1 to 3 hours.

What happens after shoulder arthroscopy? — 

You will be taken to a recovery room. The staff will watch you closely as the anesthesia wears off. Most people can go home the same day.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●You might need to wear a sling or brace after surgery to support your arm or limit shoulder movement.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of shoulder arthroscopy? — 

Your doctor will talk to you about all the possible risks, and answer your questions. Possible risks include:

●Infection

●Bleeding

●Damage to blood vessels, nerves, or other parts of the shoulder

●Blood clots

●Ongoing pain and stiffness, or weakness

●The doctor not being able to fix the problem, or needing to do an open surgery

What else should I know? — 

Before you go home, make sure you know what problems to look out for and when you should call the doctor. Make sure you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Shoulder arthroscopy – Discharge instructions (The Basics)
Patient education: Arthroscopy (The Basics)
Patient education: Minimally invasive surgery (The Basics)
Patient education: Shoulder pain (The Basics)
Patient education: Shoulder impingement (The Basics)
Patient education: Shoulder replacement (The Basics)
Patient education: Frozen shoulder (The Basics)
Patient education: Rotator cuff injury (The Basics)
Patient education: Separated shoulder (The Basics)
Patient education: Bursitis (The Basics)

Patient education: Shoulder impingement syndrome (Beyond the Basics)
Patient education: Frozen shoulder (Beyond the Basics)
Patient education: Rotator cuff tendinitis and tear (Beyond the Basics)
Patient education: Acromioclavicular joint injury (shoulder separation) (Beyond the Basics)
Patient education: Bursitis (Beyond the Basics)