Until recently, shoulder surgery required large incisions, leaving large scars and pain after surgery. But with the advancement of optical and orthopaedic technology, we can now perform many shoulder procedures by making very small incisions and using a camera (arthroscope) to view the inside of the shoulder and fix it.
Benefits of Shoulder Arthroscopy
The advantages of shoulder arthroscopy are:
- Smaller scars
- Less anesthesia
- Less pain after surgery
- Faster recovery
Every year, new instruments are introduced which make arthroscopic surgery easier and more successful. Dr. Anthony Romeo has been very instrumental in the introduction and design of many of the shoulder arthroscopic procedures performed today. He performs all of his sports medicine procedures—including repairing torn rotator cuffs and stabilizing loose shoulders, as well as many other procedures—using advanced arthroscopic techniques.
Arthroscopic Shoulder Surgery Details
Prior to surgery, most patients are given a numbing block in their shoulder and neck to anesthetize the nerves connected to the shoulder. Because patients require much less anesthesia during an arthroscopic surgery, they routinely go home the same day and have a more comfortable recovery.
After anesthesia is administered, the patient is either placed in a sitting position or lying-on-the-side position. This is decided based on the area of the shoulder which requires attention.
Two to four small incisions (under ¼”) are made around the shoulder. The arthroscope (camera) is then introduced in the main shoulder joint. Sterile salt water is used to inflate the joint and allow safe placement of other instruments into the shoulder. Small instruments are used to test the areas of concern to diagnose any abnormalities or tears. Photographs and videos are taken of the different parts of the shoulder to document its condition. Shavers are used to remove damaged tissue, while sutures and sometimes anchors fastened into the bone allow Dr. Romeo to repair torn tissues.
At the conclusion of the procedure, sutures are used to close the small skin incisions and small band-aids (Steri-strips) are placed over the incisions with sterile dressings. When possible, Dr. Romeo encourages the use of a cooling device after surgery to help reduce swelling and minimize pain, which allows the patient to reduce or stop pain medications more quickly after surgery. If a patient elects to have a cooling device, when they wake up after surgery, they will find a cooling pad over their shoulder. This cooling pad is connected to a container filled with ice and circulates cold water to control post-operative pain. After the surgery is completed and before the patient goes home, the surgical team will frequently check the circulation in the arm and as well as look for excess swelling or other problems.
Want to see an arthroscopy in action? Dr. Romeo demonstrates arthroscopic shoulder surgery on a Major League Baseball Player:
Shoulder Arthroscopy Recovery
Recovery from an arthroscopic procedure is quicker than recovery from major surgery due to the fact that the normal tissues around the shoulder are minimally affected by the small incisions and instruments used for arthroscopic surgery. Some swelling is a normal part of the recovery process. Cold therapy, either with a cooling pad or with ice packs applied to the shoulder several times a day, can help ease swelling and discomfort. Dr. Romeo will give you specific instructions for post-op pain management.
After surgery, a sling is worn for a number of weeks. While wearing the sling, the patient is able to move their elbow, wrist, and hand, but shoulder motion is generally restricted. After surgery, physical therapy will begin when it is safe to work on improving motion and then strength. A normal course of physical therapy often includes up to three months of supervision from the therapist, then a gradual transition to desired activities, sports, and work.
Things to Stay Alert for During Recovery
As your shoulder recovers, it is important to stay alert for any red flags of infection or other healing problems. Fortunately, these are rare.
Warning signs include:
- increasing numbness or tingling sensations, especially if it radiates into your hand
- Increasing pain near your incision
- bleeding or other discharge
- swelling that is beyond what is expected
How to Schedule a Shoulder Surgery Consultation
For more information about effective solutions for rotator cuff injuries, please request an appointment with experienced Chicago orthopaedic surgeon Dr. Anthony Romeo. Call or email our office today to schedule your visit.
If you would like to learn more about the anatomy of the shoulder, please see Dr. Romeo’s video:
Anthony Romeo, MD
Dr. Anthony Romeo is one of the nation’s leading orthopaedic surgeons specializing in the management and surgical treatment of shoulder and elbow conditions. His state-of-the-art practice employs minimally-invasive arthroscopic techniques to accelerate the recovery process for a range of challenging conditions.