The information provided in this website is aimed to provide a general overview of hip arthroscopy. By no means does this document offer a fully comprehensive review and any questions should be discussed with your surgeon. There are significant variations of shoulder arthroscopy techniques from surgeon to surgeon.
Arthroscopy is an orthopedic surgical procedure whereby the surgeon can evaluate and treat the shoulder joint. Arthroscopy is performed with the use of a camera and minimally invasive instruments. The first documented arthroscopy dates back to nearly a century ago during the 1910's when it was used as a diagnostic tool to evaluate the joint. Several years later, with advancements in the camera, optics, and techniques, arthroscopy become useful in the treatment of joint pathology such as meniscus tears in the knee joint. Currently, arthroscopy is a mainstay procedure for shoulder, elbow, wrist, hip, knee, ankle and foot disorders. The shoulder is an ideal joint for arthroscopy, especially in the treatment of rotator cuff tears, instability, labrum tears, SLAP lesions, and impingement.
There are several benefits of arthroscopic surgery. The potential benefits over open shoulder surgery are: 1) less surgical injury - the arthroscope is inserted through small 1-2 cm incisions, or portals, that split the muscle fibers. When the camera is removed, the muscle fibers return to their normal position and alignment. This therefore minimizes contact with normal structures. This also results in 2) less surgical pain and potentially 3) faster recovery time. The cameras also provide 4) better visualization of the injured structures and therefore the surgeon is able to 5) perform a more anatomically correct repair. Another benefit of arthroscopy is that the procedure can be performed as an 6) outpatient procedure and the patients can often go home within a few hours after the procedure. All of these lead to improved overall outcomes and patient satisfaction.
By other diagnostic tests, such as ultrasound or MRI scan.
How Are Tears Treated Without Surgery?
Anti-inflammatories (Motrin, Aleve) or Tylenol.
What Happens If Tears Are Not Surgically Repaired?
In some cases, the pain improves with time.
Some tears may become larger with time.
Some small tears may heal.
Larger tears may lead to shoulder joint arthritis.
What Happens If I Wait to Repair My Tendon Tear?
Some people will eventually improve.
The tendon may retract and the muscle may atrophy
Tears may not be repairable if too much time has elapsed.
How Are Rotator Cuff Tears Treated Surgically?
Either open or using arthroscopic techniques.
What Is Arthroscopic Surgery?
A camera is inserted into the shoulder and the surgeon visualizes the shoulder through a video monitor.
A minimally-invasive surgical technique that avoids significant soft-tissue injury.
What are the Benefits of Arthroscopic Surgery?
A less invasive procedure with the benefits:
Less surgical dissection.
Less surgical pain.
Faster recovery rates
Better visualization of the shoulder anatomy.
What is the Success Rate of Arthroscopic Rotator Cuff Repair?
The success rate is anywhere from 60-100%.
Several important factors influence outcome such as: age, diabetes and other medical problems, smoking, size of the tear, how long ago the tear occurred, and patient compliance with the instructions after surgery.
What Holds the Tendon to the Bone?
The tendon can be repaired using suture anchors allowing the tendon to be sutured back to the bone.
Anchors can be absorbable or non-absorbable, like metal.
When and Why Should I Have Surgery?
If you continue to have pain despite therapy and medications.
If you wish to restore tendon function and relieve pain.
Earlier repairs have better outcomes than delayed repairs.
Is There An Age Restriction for Surgery?
Success is higher in patients under the age of 70, however, age itself is not the limiting factor.
A careful pre-operative assessment from your medical internist can determine if you are a candidate for surgery.
What Type of Anesthesia Will I Have?
Arthroscopies are performed under general anesthesia.
A nerve block may also be performed for pain relieve after surgery.
What Can I Expect the Night Before Surgery?
You may take your regularly scheduled medications.
Certain medications must be stopped before surgery (such as blood thinners). A complete list of these medications will be given to you by our office staff.
Do not eat or drink after midnight before your surgery.
You will be contacted by the hospital or surgical center the day before surgery.
You will be notified: when to arrive for your surgery,when you should not eat, and what medications you may continue to take. They will be helpful in answering questions you mayhave concerning medications, transportation, and other concerns.
Is My Surgery Outpatient and Same Day Surgery?
The majority of arthroscopic cases are outpatient procedures and patients are allowed to go home the same day of their procedure.
In certain cases, patients may stay overnight for observation at the hospital and will be allowed to go home in the morning after surgery.
What Happens If I Have an Anesthesia Nerve Block?
Patients who have a nerve block, will have prolonged anesthesia to the shoulder and arm and may go home with the arm still "numb".
Therefore, be careful to avoid any pressure or injury to the shoulder and arm as you will not feel the pain until the block has worn off.
Can I Drive Home After Surgery?
You should arrange transportation with family, friends, or other means for after surgery.
Do not drive home after having been administered anesthetics.
Driving is NOT permitted for 2-6 weeks after surgery depending on the type of procedure performed.
What Kind of Pain Can I Expect Following Surgery?
As with any surgery, there will be surgical pain. The benefit of minimally-invasive arthroscopic surgery is the limited amount of surgical dissection and faster recovery time.
You will be prescribed narcotic medication to go home with.
Do NOT make important decisions while taking narcotic medications.
What Should I Avoid After Surgery?
Do not attempt to lift the arm "actively" by yourself until directed.
Do NOT remove the sling. Remove the sling only for hygiene.
The tendon is repaired to bone with sutures and will take about 6 weeks to heal onto the bone and even longer for a firm repair. Early activity may cause failure of your repair.
Do NOT make important decisions immediately after surgery or while on narcotic medications.
When and How Do I Bathe or Shower After Surgery?
Do not bathe or submerge the shoulder in a pool until you have been cleared.
You may shower after 72 hours if the incisions are dry.
When Do I Remove the Dressings?
You may remove the shoulder dressings after 72 hours.
Please do NOT remove the white sticky "steri-strips".
Towel-dry the incision and place a band-aid over the steri-strips after showering.
What Pain Medications Do I Take After Surgery?
You will be prescribed a narcotic for pain relief after surgery.
You should continue the medications for at least 72 hours as directed and then wean the medications when you are able. This avoids unnecessary build-up of pain.
How do I Wean Pain Medications After Surgery?
Weaning narcotics is best done by alternating Tylenol in place of a regularly scheduled narcotic pill at every other scheduled narcotic dose.
Narcotics are eventually discontinued altogether.
Narcotics can make you constipated, nauseous, and can affect your ability to make decisions.
Do I Wear a Sling After Surgery?
The shoulder M U S T be maintained in a sling for 6 weeks (day and night time) except for showers, baths, and therapy.
Non-compliance with immobilization can cause failure of the repair.
What Shirt Should I Wear to Surgery?
Bring a loose fitting shirt (button-down or over-sized large T-shirt).
The arm is placed in the sling. The shirt is placed over the arm and sling.
Do I Receive Rehabilitation After Surgery?
Therapy begins according to a strict therapy schedule usually 2-4 weeks after surgery depending on the strength and size of repair.
Physical therapy continues over a 16-week period progressing from full immobilization to full active return to activities.
It will take approximately 4-6 months before returning to full overhead activities, golf and other activities.
Return to full activity depends on the size of the tear, activity requirements, and the repair strength.
Each patient has an individually designed rehab program.
Where Can I Do Therapy?
Therapy is performed with a licensed therapist usually at approved outpatient therapy centers.
Dr. Hommen will tailor a therapy protocol according to your shoulder needs that the therapist will follow.
When Can I Drive After Rotator Cuff Repair Surgery?
Usually sometime after 4-6 weeks after surgery.
Common Questions Regarding SLAP lesions and Labrum Tears and Surgery: