Anatomy And Function Of The Shoulder
The shoulder is a ball-and-socket joint and has the greatest range of motion of any joint in the body. Because of this mobility, it is at risk for injury or degenerative problems. The bones of the shoulder are the humerus (upper arm bone), clavicle (collar bone), and scapula (shoulder blade). The head of the humerus bone (the ball) is lined with cartilage that glides over the shoulder socket (also known as the "glenoid cavity"). The clavicle attaches the shoulder to the rib cage and holds the shoulder out from the body. The scapula is a large triangular bone located on the back side of the upper body, and it is connected to the clavicle through the acromioclavicular (AC) joint.
In the shoulder socket, the humerus sits like a golf ball on a tee, supported by a complicated arrangement of muscles, tendons, and ligaments. The rotator cuff is a group of tendons that attaches four shoulder muscles to the upper arm. These tendons help keep the humerus bone in place within its shallow socket and ensure that the arm moves freely within the joint.
Nonsurgical Options (Shoulder)
There are some nonoperative, conservative options to consider for the treatment of a rotator cuff tear or shoulder instability:
Ice Packs. Reduce swelling while resting the arm.
Anti-inflammatory Medications. Decrease swelling in the joint and provide temporary pain relief. Please note, however, that all medications have risks and should be taken only in consultation with your pharmacist and physician.
Physical Therapy. Helps shoulder to regain normal motion and strengthens muscles.
What is Arthroscopic Shoulder Surgery?
In the late 1970s and early 1980s, arthroscopic surgery became popular, especially in the sports world, as fiber-optic technology enabled surgeons to see inside the body using a small telescope, called an "arthroscope," which projects an image to a television monitor. Thanks to ongoing improvements made by technology leaders like Smith & Nephew, arthroscopic surgery is now accessible to more people than just professional athletes. In fact, active patients all over the world have experienced the benefits of minimally invasive surgical procedures.
Through an incision the width of a straw tip, your surgeon is able to insert an arthroscope that allows him or her to inspect your joint and locate the source of your pain. The arthroscope can also help visualize tears or other damage that may have been missed by an X-ray or MRI. Your surgeon will then make one or more small incisions to accommodate the instruments used to repair the shoulder. These instruments can shave, trim, cut, stitch, or smooth the damaged areas.
Arthroscopic shoulder surgery is often performed in an outpatient surgery center, which means no overnight hospital stay is required. You report to the surgical center in the morning, undergo the procedure, and - following a recovery period under the care of medical professionals - return home later in the day.
Postoperative Care
After surgery, you will be transported to the recovery room for close observation of your vital signs and circulation. You may remain in the recovery room for a few hours.
When you leave the hospital, your arm will be in a sling. The sling should be worn for the amount of time recommended by your physician.
Rehabilitation
Steps for rehabilitation following rotator cuff surgery and instability repair vary from physician to physician. To learn what activities will be involved in your own rehabilitation, consult your doctor.
Who Is A Candidate For Arthroscopic Shoulder Surgery?
Patients with shoulder pain or limited shoulder function may be candidates for arthroscopic shoulder surgery. Most people who suffer from a shoulder injury and who have not found the relief they need through nonoperative treatments may benefit from a minimally invasive surgical procedure. The information in this brochure will help you better understand the anatomy and function of the shoulder, as well as the effects on the shoulder of a rotator cuff tear or the condition known as "shoulder instability." In addition, it will guide you through the steps of arthroscopic shoulder surgery for the treatment of these conditions.
Reasons For Arthroscopic Shoulder Surgery
Minimally invasive shoulder surgery is a positive measure to regain the active lifestyle that a painful shoulder is preventing.
Arthroscopic shoulder surgery can:
- Relieve pain.
- Improve joint stability.
- Repair tears and damage.
- Maximize quality of life.
- Optimize activities of daily living.
Preparation For Arthroscopic Shoulder Surgery
Preparation for your surgery begins weeks and sometimes months before the surgery date. Here are just a few events and considerations that you may experience:
Initial Surgical Consultation. Preoperative X-rays, a complete medical history, a complete surgical history, and a complete list of all medications (i.e., prescription, over-the-counter, vitamin supplements) and allergies will be reviewed.
Complete Physical Examination. Your surgeon will perform a physical examination and determine if your internist or family physician should assist with optimization of medical conditions prior to the surgery. This will ensure that you are in the best physical condition possible on surgery day.
Physical Therapy. Instruction in an exercise program to begin prior to surgery, as well as an overview of the rehabilitation process after surgery, will better prepare you for postoperative care.
Preparation for Surgery. You may want to wear loose-fitting clothes. You should bring your insurance information and a list of all your medications and dosages as well as drug allergies. You will need to arrange for someone to drive you home.
Evening Before Surgery. Do not eat or drink after midnight. Your surgeon or anesthesia provider may recommend that you take some of your routine prescription medications with a sip of water.
