Shoulder arthroscopy is a minimally invasive method used for better diagnosis and treatment of various injuries in the shoulder joint area. It is a modern technique that allows visualization inside the joint to diagnose and treat problems without the need for hospital admission.

The shoulder is a joint that performs movements in multiple planes and, therefore, is particularly prone to injuries.

In the past, the only treatment option was open surgery, which involved significant joint trauma, prolonged hospitalization, and immobilization of the shoulder with pain lasting several weeks.

Today, the pioneering method of arthroscopy solves these problems and should only be performed by specialized orthopedic surgeons.

Shoulder Arthroscopy / Indications

Shoulder arthroscopy is mainly performed to address the following conditions:

• Early arthritis
• Damage or injury to the articular cartilage
• Shoulder stiffness (Frozen Shoulder)
• Selected fractures
• Persistent calcific tendinitis
• Rotator cuff tear
• Tear of the labrum and shoulder ligaments in dislocations or acute and chronic instability
• Pathologies of the long head of the biceps tendon
• Pathologies of the synovial membrane
• Suprascapular nerve compression
• Impingement syndrome
• Presence of free intra-articular bodies

Shoulder Arthroscopy / Description

The orthopedic surgeon inserts an arthroscope through small incisions (about 3-5 millimeters) into the shoulder joint. The arthroscope contains a tiny camera with strong lighting and is connected to a special monitor where a highly magnified, clear, and color image is displayed.

This allows the surgeon to:

• Carefully examine the inside of the shoulder joint and diagnose with great accuracy any injuries, even very small ones, and in hard-to-reach areas
• Repair intra-articular and periarticular injuries using specially designed, very fine tools and implantable inert materials such as sutures and anchors. For example, the surgeon can repair torn tendons, release adhesions, and fix injuries caused by dislocation (e.g., labrum repair).

In most cases, shoulder arthroscopy lasts about one hour. It is performed under a combination of regional and light general anesthesia depending on the patient’s history, and the patient usually goes home the same day.

Advantages

Arthroscopic Techniques

Different advanced arthroscopic techniques are applied depending on the type and severity of the injury.

In simple injuries, immediate repair (suturing) is performed, while in more severe cases where immediate repair is not possible, the latest techniques according to international literature are used. In massive irreparable rotator cuff tears, reconstruction of the superior joint capsule may be performed using grafts from the patient’s own tissue or tendon transfers to substitute the function of a muscle. In recurrent dislocations and cases with large bony defects of the shoulder joint, arthroscopic placement of a bone graft (bone block) from the iliac bone or transfer of the coracoid process (Latarjet procedure) is performed.

Postoperative Rehabilitation

After surgery, the use of a special shoulder sling is usually recommended for the first days, allowing the patient to use the arm for basic daily functions. Postoperative pain is generally minimal, and simple oral painkillers are given preventively for the first days.

The patient should be regularly monitored by the physician to check wound healing progress and receive necessary instructions for mobilization. Sutures are usually removed after 8-10 days.

Successful postoperative recovery requires that the patient follows a special physiotherapy rehabilitation program.

Physiotherapy

Physiotherapy is essential for patient recovery, mainly consisting of exercises that the patient can perform at home under the guidance of the physiotherapist or physician. The physiotherapy program is personalized based on the type and extent of the injury repaired arthroscopically.