Arthroscopic Shoulder Surgery
Arthroscopic (Keyhole) shoulder surgery may be used to address a wide variety of shoulder pathologies. It has some advantages over more traditional open surgery including a quicker recovery and the ability to address several issues at a single sitting.
It involves making several small incisions around the shoulder under anaesthetic through which the operation occurs using specific instruments.
Click the links below (in red) for more information on the surgical management of specific conditions
Impingement and Acromioclavicular Joint Arthritis
Impingement is a dynamic problem caused by the loss of co-ordinated movement between the shoulder and the shoulder blade.
It is a common cause of pain and is often managed adequately by a combination of steroid injections and physiotherapy.
It may be associated with bony spurs and arthritis of the acromio-clavicular joint both of which may be amenable to surgical intervention this is known as sub-acromial decompression and arthroscopic ACJ excision
Rotator Cuff Disease
The rotator cuff is the collective name given to the tendons which help to control shoulder movement.
It is not uncommon for them to become tendonopathic (damaged) or torn.
Depending on the size and location of the tear it is possible that the remaining tendons compensate for the damage. If the tear is uncompensated there may be a role for surgical repair. I generally classify tears into small or large depending on dimensions.
Frozen shoulder is stiffness of the shoulder related to scarring of the soft tissue lining of the shoulder joint (the capsule). It may be spontaneous or may be related to trauma or surgery.
In the early stages or in mild cases it may be managed by physiotherapy. More severe cases may require intervention either by guided injection (hydrodilation) or surgical release
Long Head of Biceps Pathology
The long head of biceps is the smaller of the two heads. It contributes minimally to the function of biceps but may be associated with pain in the shoulder
The long head of biceps may often contribute pain in shoulders with underlying wear and tear arthritis particularly if the rotator cuff is also damaged.
Post Traumatic Instability and SLAP lesions
The shoulder has little in the way of bony stability. It is a large head resting on a small socket. It therefore relies on the soft tissue stabilisers.
The labrum of the shoulder contributes to the stability and it is this structure which is most commonly injured in traumatic dislocations.
Often the muscles that cross the shoulder can compensate for labral tears and hence physiotherapy can allow many patients to return to pre-injury levels of function following a single dislocation.
The risk of becoming recurrently unstable is related to young age.
Arthroscopic surgery may be used to repair labral tears.