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Shoulder Arthroscopy

What is shoulder arthroscopy?

  • Shoulder arthroscopy is ‘keyhole’ surgery to the shoulder

  • A camera is placed inside the shoulder and any surgery inside the shoulder is done through small incisions in the skin

What is Shouldr Arthroscopy?
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What conditions can it be used for?

Wha conditions?

  • Removal of calcium deposits in the shoulder that cause ongoing pain

  • Infection of the shoulder joint that needs to be drained and debrided

  • Rotator cuff repair, biceps tenodesis, acromioplasty (see separate information sheet)

  • Stabilization of a dislocating/unstable shoulder

  • There are many others.

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How does surgery work?

  • This kind of surgery usually requires a general anesthetic (being ’completely knocked out’)

  • Often the anesthetist does a nerve block (that numbs and paralyses the arm for about 12 hours) to help with pain relief – it can be very painful surgery.

  • Because it can be quite sore immediately after surgery - It is recommended to stay in hospital overnight

  • Antibiotics is usually administered at the time of surgery, and may have to be continued after surgery in cases of injection

How does surger work?

What do we do in surgery?

  • Surgery usually takes about 1-2 hours

  • But the whole process of going to theatre and waking up from surgery takes longer.

  • Often the surgery is done with the help of a camera (arthroscopic, or ‘keyhole’).

  • Sometimes a larger skin cut is needed to for successful surgery

What do we do in surgery?

After the Surgery?

In Hospital

  • The wounds are dressed, and the arm is placed in a sling

  • We often leave a pain catheter in the shoulder to deliver more local anaesthetic at about 10 hours after surgery (when the anaethetist’s nerve block starts to wear off)

  • Do not hesitate to ask for pain killers. It is much better to ‘stay on top of pain’,  than ‘to catch’ up when it is severe.

  • It is usual to leave hospital the morning after surgery

  • A physiotherapist will usually visit you in hospital to demonstrate gentle exercises.

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At Home

  • Continue to stay on top of your pain with oral pain killers.

  • Do the gentle exercises that physiotherapist demonstrated in hospital. It is usually advised to see a physiotherapist in the community at around 2-4 weeks post surgery.

  • It is OK to remove your sling to do these exercises. Your surgeon will let you know how long a sling needs to be used for.

  • While the shoulder wounds are covered with waterproof dressings it is safe to have a shower. Please have the dressings replaced if they start to come loose.

  • An appointment is usually made at my rooms to review your progress 1-2 weeks after the surgery

  • Please do not drive before speaking to your physiotherapist or a doctor.

After the Surgey

The recovery?

  • The recovery depends a lot on the kind of surgery required. Please follow advice from your surgeon and physiotherapist carefully.

  • A sling is usually worn, in some cases full time for up to 6 weeks

  • From around 2 weeks on, a physiotherapist can show you how to start to progress your range of motion exercises.

  • It can occasionally take up to a year to regain completely normal range of motion.

 

Time frames

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  • Self care (washing, dressing, eating) with the operated hand – usually around 1-6 weeks (a sling may still be needed) depending on the surgery.

  • Driving: when you are able to control a steering wheel with your operated arm and you are not taking strong pain relief anymore (usually 4-8 weeks post surgery)

  • Office work 2-6 weeks, manual work 3-6 months.

  • Golf, fishing, cycling etc.: usually around 1-4 months, but it can be longer (6 months)

The recvery

What can go wrong?

  • Infection occurs rarely (1% of the time), but can be severe. It may need further operations, weeks in hospital.  It can lead to a poor outcome.

  • There may be ongoing pain from other worn out joints in the area, that were not obviously a problem at the time of doing the surgery.

  • It is common to have a bit of numbness next to the scar. Very rarely, severe nerve damage can occur, resulting in paralysis or numbness in the arm.

  • Around 10-15% of the time more than expected stiffness occurs in the shoulder (frozen shoulder).  It can take 2 years or more to get better.

  • Any repair that was done in the shoulder can fail, may not heal completely and cause ongoing pain in the shoulder.

  • A general anesthetic can have complications, such as nausea, heart and lung problems. Please discuss it with your anesthetist before the operation.

What can go wrong?

What can you expect the final outcome to be?

  • Most patients experience significant improvement in their shoulder pain and function.

  • Mild discomfort and stiffness commonly persist despite successful surgery.

  • Strength usually recovers, but it can take up to 1-2 years to reach maximal improvement.

What canyou expct?

FAQ

  • How long will the surgery take / How long will I be in hospital? 

    • about 2 hours, overnight

  • Which hospital?

    • The Sunshine Coast University Private Hospital

    • Or Kawana Private Hospital

  • Anything I should do to prepare for surgery?

    • You should make sure that you have no pimples or skin breaks around your shoulder. 

    • if there are any pimples it should be washed with benzoil peroxide.

    • Stop any drugs or supplements that may cause thinning of blood (anti inflammatories, fish oil etc.)

    • Make sure that you have help at home for after surgery; you will need a sling for 6w and cannot drive for at least 6w

    • don't smoke

  •  After care - showering, etc

    • as long as waterproof dressings are securely in place showering is safe

  • Will I be in a sling?

    • yes for 6 weeks

  • Worst case scenario

    • You can get a frozen shoulder that can take 2 years to recover. 

    • The reconstruction can fail (and needs to be re done), or never be any good (uncommon in young healthy individuals.

    • Infection can make the shoulder worse than it is now, it may never recover (there is less than 1% risk of this happening)

    • Very rarely serious complications can occur from the anaesthetic, such as a stroke or heart attack.

  • Rehab - Who / Where?

    • first month: gentle exercises as demonstrated in hospital by physio

    • After that please see a physiotherapist in the community to help with further rehabilitation.

  • WC have requested a Medical table of costs – what is that?

    • We usually send a request for surgical approval to Workcover, it contains the item numbers(fees) that will be used.

FAQ
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