Arthroscopic shoulder surgery is a minimally invasive technique used to visualize, diagnose, and treat problems within the shoulder joint. This procedure involves inserting a tiny camera, called an arthroscope, through small incisions to guide miniature surgical instruments. The camera projects images onto a video monitor, allowing the surgeon to work inside the joint without a large open cut. The success of the surgery depends entirely on the specific injury and the patient’s commitment to recovery.
When Arthroscopy Is Recommended
Arthroscopy is recommended when a painful shoulder condition persists despite non-surgical treatments. This procedure is the standard for repairing many specific structural injuries inside the joint. Common conditions treated include full-thickness rotator cuff tears, which require reattachment of the tendon to the bone using anchors and sutures.
The surgery is also performed for labral tears, such as Bankart lesions caused by dislocations, or SLAP tears involving the biceps tendon anchor. Chronic shoulder instability, where the joint frequently dislocates, can be addressed by tightening the joint capsule or repairing damaged ligaments. Arthroscopy can also resolve shoulder impingement by removing bone spurs or inflamed tissue that crowd the rotator cuff tendons. A clear diagnosis, often confirmed by an MRI, is necessary before considering surgery, especially when symptoms limit function and quality of life.
Non-Surgical Paths to Consider First
Patients must exhaust a range of conservative treatments before surgery is considered. Physical therapy is the cornerstone of this approach, focusing on exercises to restore strength, flexibility, and proper movement mechanics. Activity modification and rest are also necessary, often involving temporary avoidance of overhead activities or heavy lifting.
Anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), manage pain and reduce inflammation. Corticosteroid injections provide targeted, temporary relief by delivering a strong anti-inflammatory agent directly into the joint space or bursa. Surgery is reserved for cases where these conservative measures, applied over several months, have failed to provide satisfactory pain relief or functional improvement.
The Recovery Commitment After Surgery
The success of arthroscopic shoulder surgery relies on the patient’s dedication to the post-operative recovery process. The initial phase involves protection and pain control, often requiring the arm to be immobilized in a sling for up to six weeks or more for complex repairs. Physical therapy begins soon after surgery, starting with passive range of motion exercises where the therapist moves the arm.
The next phase transitions to active range of motion, followed by progressive strengthening exercises. This strengthening phase usually starts around one to three months post-operation, focusing on rebuilding muscle power in the rotator cuff and surrounding stabilizers. Full functional recovery, including a return to sports or heavy manual labor, is a gradual process that can take four to six months or longer. Consistent attendance at physical therapy sessions is necessary, as failure to follow the rehabilitation protocol can lead to stiffness and a poor outcome.
Evaluating Success and Potential Complications
The worth of arthroscopic surgery is measured by its ability to reduce pain and restore functional strength and range of motion. Success rates are high, with positive outcomes ranging from 75% to 90% for common procedures like rotator cuff repair and labral reconstruction. The outcome can vary based on the specific injury type, with smaller tears often having higher success rates than larger injuries.
Potential complications are a consideration, though they are low compared to open surgery. The most frequently reported complication is joint stiffness, or arthrofibrosis, which occurs in a small percentage of patients. Other risks include infection, which is rare at less than 1%, and the possibility of nerve or blood vessel damage. Patients must also understand the possibility of a re-tear after a rotator cuff repair or persistent instability after a labral repair.