Shoulder Arthroscopy

Types of Shoulder Arthroscopies

A rotator cuff tear is a common shoulder injury that affects the group of four muscles and tendons responsible for stabilizing and moving the shoulder joint. It can result from acute injury (such as a fall or heavy lifting) or degenerative wear and tear over time, especially in older adults or athletes who perform repetitive overhead movements. Types of Rotator Cuff Tears –
– Partial Tear – The tendon is damaged but not completely severed.
– Complete Tear – The tear in the tendon is completely.

Symptoms

– Persistent shoulder pain, especially at night or with movement
– Weakness in the affected arm
– Difficulty lifting or rotating the arm
– A clicking or popping sensation in the shoulder

Treatment Options – Non-Surgical

– Medications
– Injections
– Rest & Activity Modification
– Physical Therapy

Treatment Options -Surgical

– Mini-Open Rotator Cuff Repair – Small incision (3-5 cm) used to directly visualize the tendon.
– Open Rotator Cuff Repair – Requires a larger incision (~5-10 cm) over the shoulder. Deltoid muscle is detached for better access to the tendon.
– Arthroscopic Rotator Cuff Repair (Minimally Invasive) – Performed through small incisions using a camera (arthroscope) and specialized instruments. Torn tendon is reattached to the humeral head using suture anchors. Sutures and anchors (metal or bioabsorbable) are used to reattach the tendon to the bone.

Advantages of Rotator Cuff Repair:

– Smaller Incisions & Less Tissue Damage
– Reduced Postoperative Pain
– Faster Recovery & Rehabilitation
– Lower Risk of Infection & Complications
– Better Visualization & Precision
– Less Scarring & Better Cosmetic Outcome
– Improved Shoulder Function -With proper rehabilitation, patients regain better mobility and strength, often achieving full recovery in 6-8 months.

Recovery

– Non-surgical treatment: Several weeks to months
– Surgery recovery: 4-6 months (may take up to a year for full strength depending upon the after operative adherence to rehabilitation).

Tips for Recovery

– Follow your surgeon’s and physical therapist’s guidelines.
– Avoid lifting, pushing, or pulling too soon.
– Stick to your physical therapy plan to prevent stiffness and re-injury.
– Be patient—it’s a slow but essential process for full recovery.

Risks & Complications

– Stiffness or frozen shoulder
– Re-tear of the tendon
– Infection or bleeding
– Nerve damage (rare)

Shoulder Impingement Syndrome

Shoulder Impingement Syndrome is a condition where the tendons or bursa in the shoulder become compressed or irritated, leading to pain and reduced mobility. It often occurs due to repetitive overhead movements, poor posture or muscle imbalances.

Causes

– Repetitive use (e.g., swimming, baseball, weightlifting)
– Poor posture (rounded shoulders, forward head position)
– Muscle imbalances or weakness
– Bone spurs or anatomical narrowing
– Inflammation from overuse or injury

Symptoms

– Pain in the front or side of the shoulder
– Difficulty reaching overhead or behind the back
– Weakness or stiffness in the shoulder
– Pain that worsens at night or with movement

Treatment

– Rest & Activity Modification.
– Ice & Medications – To reduce pain and swelling.
– Physical Therapy – Strengthening rotator cuff muscles and improving posture.
– Injections – If conservative treatments don’t help.
– Surgery (if severe) – Arthroscopic subacromial decompression is the procedures in which the subacromial decompression to create more space through small incisions using a camera (arthroscope) and specialized instruments.

Recovery

– Immediate pain relief after the surgery.
– Full Recovery (3-6 Months)
– Regained Strength & Function: Can resume sports and heavy lifting with clearance from a therapist.
– Final Improvements: Some minor stiffness or discomfort may persist but gradually fade.

Frozen Shoulder

Also called as adhesive capsulitis, is a condition that causes pain, stiffness and reduced range of motion in the shoulder joint. It usually develops gradually and can take months or even years to fully resolve.

Treatment Options

– Medications.
– Injections.
– Physio therapy.
– Surgical: Manipulation under anaesthesia or arthroscopic surgery. After surgery, physio therapy is essential to regain full movement and prevent stiffness from returning.

Advantages of Surgery

– Faster Recovery – Surgery can significantly speed up the recovery process compared to waiting for the condition to resolve on its own (which can take 1-3 years).
– Improved Range of Motion – Procedures like manipulation under anaesthesia (MUA) or arthroscopic capsular release help break up scar tissue, restoring shoulder movement more quickly.
– Pain Relief
– Low Risk & Minimally Invasive

Rehab Tips for Faster Recovery

– Do exercises daily to prevent stiffness from returning.
– Use heat before exercise (to relax muscles) and ice after (to reduce inflammation).
– Stay patient – full recovery can take 3-6 months or longer.
– Listen to your body – avoid overdoing it to prevent setbacks.

Risks

—–s

Labral Injuries

Also called as Bankart lesion is an injury to the anterior-inferior labrum of the shoulder joint, usually caused by an anterior shoulder dislocation. It occurs when the ball of shoulder joint forcefully pushes against the labrum, tearing it from the socket rim of the shoulder blade.

Causes

– Traumatic anterior shoulder dislocation (most common)
– Repetitive overhead movements (e.g., in athletes like swimmers, baseball pitchers)
– Falls or direct trauma to the shoulder

Symptoms

– Shoulder instability (feeling like the shoulder may “slip out”)
– Pain, especially with overhead or throwing movements
– Weakness and reduced range of motion
– Clicking or popping sounds during movement

Treatment

The treatment for a Bankart lesion depends on the severity, the patient’s activity level, and whether there is chronic instability. It is usually categorized into non-surgical management and surgical intervention.

Surginal and Non-Surgical Options ->

Non-Surgical

– Medication
– Physical therapy to strengthen muscles.
– Activity modification.
– Non-surgical treatment works best for low-risk individuals but has a high recurrence rate.

Surgery is often recommended for

– Recurrent dislocations (especially in younger patients)
– Athletes involved in overhead sports
– Large labral tears or associated bony damage (bony Bankart lesion)

Surgery – Labrum Repair

– Also known as Arthroscopic Bankart Repair
– Most common procedure
– Minimally invasive (small incisions, done with a camera)
– Sutures and anchors are used to reattach the torn labrum to the glenoid

Recovery
– Physical therapy starts early, but full return to sports: 4–6 months

Latarjet Procedure

– Used for severe bone loss (repeated dislocations, “bony Bankart lesions”)
– Bone from shoulder blade is transferred to reinforce the socket rim of shoulder joint.
– Creates a bony block to prevent further dislocations

Recovery
– Sling for 3–4 weeks
– Gradual return to activity over 4–6 months

Surgical Success Rates

– Bankart repair: 85–95% success rate
– Latarjet procedure: Lower recurrence rate, preferred for high-risk cases
– If left untreated, a Bankart lesion can lead to chronic shoulder instability and an increased risk of repeated dislocations.