The shoulder is particularly susceptible to injury in comparison to other joints. It is a flexible ball-and-socket joint that is one of the most mobile, with a wide range of motion, supported by ligaments, tendons and muscles. The cartilage that covers the shoulder joint is also often thinner than it is in weight-bearing joints, such as the knees and hips. Most shoulder problems relate to injuries to these soft tissues.
For most shoulder conditions, Mr George-Malal would initially try non-operative treatment modalities including injections and physiotherapy to restore function and reduce any pain and discomfort. Surgery is often only required for a small minority of patients and will be advised if it is the most appropriate course of action.
Shoulder arthroscopy is keyhole surgery of the shoulder joint. Mr George-Malal uses small incisions and special equipment to thoroughly examine the joint and treat various conditions that previously required significant cuts through the skin and damage to surrounding muscles.
This has resulted in faster recovery and much less interference with normal tissues, not to mention the cosmetic advantages. Keyhole surgery may also have lower infection rates compared to open surgery.
Nowadays, most procedures in the shoulder except for complex fractures or joint replacements can be safely performed through keyhole incisions. It also has the advantage of being a day case surgery where you come to the hospital on the day of the operation and go home later in the day.
What conditions can shoulder arthroscopy treat?
Most shoulder problems result from injury, repetitive strain and age-related wear and tear. Shoulder conditions it can treat include the following:
• Rotator cuff repair
• Shoulder impingement
• Shoulder dislocation repair
• Arthritic conditions around the shoulder
• Repair of shoulder ligaments
• Removal of loose cartilage
• Allograft interposition for cuff tears that cannot be repaired
• Repair of fractures
• Nerve release
What happens during a shoulder arthroscopy procedure?
During the operation, a very tiny camera known as an arthroscope is inserted into the shoulder joint through a tiny incision. Mr George-Malal can then diagnose the issue and, if required, miniature surgical instruments can be inserted through the small incisions to repair the shoulder joint.
Shoulder arthroscopy is typically performed as a day case procedure conducted under a general anaesthetic and nerve blocks. It usually lasts between 45 minutes to 1.5 hours.
What are the advantages of shoulder arthroscopy over open surgery?
The incisions in keyhole surgery are much smaller than those in open surgery. Typically, this means less soft tissue damage, resulting in less post-operative discomfort, and you make a faster recovery and get back to what you want to do in life, whether it be work or leisure. You would also be able to go home the same day after the surgery, and there are no long, ugly scars.
