Arthroscopic Shoulder Instability Repair
The shoulder is the most flexible joint in the body. It allows for a range of movements of the hands, however makes it the most unstable joint of the body. It is a ball and socket joint where the head of the upper arm bone (humerus) articulates to the shallow cavity in the shoulder blade (glenoid). The labrum is the fibro-connective tissue surrounding the glenoid cavity and increases its depth and surface area to provide a better fit for the half-spherical head of the long arm bone. A group of ligaments forms a capsule around the shoulder joint and plays a very important role in providing stability to the otherwise unstable shoulder joint. The stability is further enhanced by the group of tendons and muscles that join the head of the humerus to the deeper muscles.
The ball of the shoulder joint sometimes comes out of the socket partially, which is called subluxation; or completely which is called dislocation. Once this occurs, it damages and loosens the supporting capsule of tendons and ligaments around the shoulder joint making the problem more and more recurrent. This condition is termed as chronic shoulder instability.
Surgery is advised when the shoulder instability interferes with the daily life or if the instability is due to the shoulder injury.
Surgery can be an open surgery or an arthroscopic procedure.
Arthroscopy is a minimally invasive surgery done as an outpatient procedure using arthroscope. The advantages of arthroscopy are less pain and complications after the procedure as compared to an open surgery.
Arthroscope is a pen-thick instrument which consists of a lens, a light system and a camera. A button sized hole is made in the shoulder and arthroscope is inserted through the hole. Fluid flows through the arthroscope and provides the surgeon with a clear view of the inside of the shoulder joint. It also minimizes bleeding. The surgeon can see the images from the arthroscope on the monitor. Necessary surgical instruments which are also thin and small as arthroscope are introduced in the joint through separate holes one or three depending on the type of repair needed to be done in the joint. After surgery the incisions are closed by stitches or with small sterile bandage strips. Patient is kept in the hospital for few hours after the surgery for observation and is discharged the same day.
Complications of shoulder arthroscopy are infection, bleeding, damage to any nerve or blood vessel, or delayed healing after the surgery. In certain cases, stiffness of shoulder joint may occur after the surgery.
After the surgery, pain medications are given to produce pain relief. The arm of the affected shoulder is tied in a sling for a period as recommended by the doctor. Physical therapy is advised to improve shoulder mobility and strength after the surgery.