When surgery is necessary, Riverside Orthopaedic Surgeons often use a minimally invasive procedure called arthroscopic surgery. Many shoulder and most elbow conditions can be treated using out-patient arthroscopic surgery, which has the advantage of allowing the surgeon to see inside the joint with an incision as small as a quarter of an inch. A full view of your shoulder or elbow, cartilage and surrounding tissue is available via the arthroscope, a long narrow tube no wider than 1/8th of an inch with a miniature video camera attached to the end. The arthroscope is inserted inside the joint through the tiny incision. Images appear on a monitor so that your surgeon can treat a variety of conditions.
Conditions treated with anthoscopic surgery
- Loose pieces of cartilage
- Rotor cuff tears
- Frozen shoulder
- AC joint arthritis
- Bicep tendonitis
- Shoulder instability
- Golfer’s elbow
- Tennis elbow
In recent years, an arthroscopic technique called thermal capsulorrhaphy has used heat to shrink and tighten tissues involved in shoulder instability.
What to expect before surgery
Prior to arthroscopy, standard pre-operative blood and urine tests may be done as well as scans of the affected joint, such as:
- MRI (magnetic resonance imaging),
- CT (computed tomography) or
- arthrogram (an x ray using dye).
In some cases, you’ll be given an exercise regimen to strengthen muscles around the joint prior to surgery.
The day of surgery
Arthroscopic surgery is performed at a Riverside outpatient surgery center or one of the Riverside hospitals. The surgery usually takes 30 minutes to 2 hours. Most patients are discharged the same day, but occasionally depending on the complexity of the procedure and the patient’s condition, a hospital stay is recommended.
Before the surgery
- You'll need to wear loose fitting clothing to allow for bulky dressings over the surgical site.
- You’ll be asked to change into a gown.
- While you are waiting for the procedure to begin, you’ll be given a mild sedative to relax you.
- Cloths will be draped so that only the shoulder or elbow injection area is exposed. The rest of you will be covered.
- Depending on the complexity of the surgery, you’ll be given general, regional or local anesthesia.
During the procedure
- You’ll be placed in a position that allows the surgeon to easily reach the injured joint.
- After sterilizing the area, the surgeon will make a small incision or incisions in the skin and inject a sterile solution that will expand the joint for better viewing and movement of the instruments.
- The joint will be irrigated several times during the surgery to remove debris and fluid out of the way.
- The arthroscope is inserted and while looking at the interior of your shoulder or elbow on the monitor, your surgeon can use tools such as a laser or tiny scalpels to correct or repair problems.
- Once the procedure is done, the joint is irrigated again and the site of the incision is dressed with bandages.
- Afterwards, you’ll be moved to a recovery area to wait for the anesthesia to wear off which will take a few hours.
- You’ll have ice packs placed on your incision site.
- Once discharged, you’ll need someone to drive you home. Some patients may spend the night in the hospital, if the surgeon believes that their condition warrants it.
After the surgery
- The incision wounds will heal in a few days.
- The joint will take several weeks to fully recover.
- The stitches will be taken out in about a week at your doctor's office.
- Your daily activities can be resumed within a few days to a week.
- You can return to work within a few days to a week.
You should feel significantly better. While your joint may feel great, the shoulder still needs time to heal. As you regain muscle strength, you must be careful not to overdo it. For this reason, physical therapy at a Riverside facility may be recommended to speed recovery as safely as possible. With the help of your physical therapist, you’ll help reduce future pain by building up strong shoulder and arm muscles.