Shoulders Arthroscopy

Shoulder arthroscopy is a type of surgery to examine or repair the tissues inside or around your shoulder joint. The procedure uses a small camera, called an arthroscope, which is inserted through a small incision. If the surgeon is going to repair the joint, small surgical instruments are also used, such as a shaver to remove unwanted tissue.
Arthroscopy may be recommended for shoulder problems, such as:

• A torn or damaged cartilage ring (labrum) or ligaments (in cases of shoulder instability)
• A torn or damaged biceps tendon
• A torn rotator cuff
• A bone spur or inflammation around the rotator cuff
• Stiffness of the shoulder
• Inflammation or damaged lining of the joint
• Arthritis of the end of the clavicle (acromioclavicular joint)t

Pocedure
An arthroscopy can take up to one and a half hours, depending on whether your surgeon is finding out the cause of your shoulder pain or repairing the shoulder joint.
Once the anaesthesia has taken effect, small cuts (about 5mm long) are made in the skin around the shoulder that is being treated. Sterile fluid is injected into the joint to help produce a clearer picture. The arthroscope is inserted through one of these cuts into the joint.
Your surgeon will then look at the joint, either directly through the arthroscope, or at pictures it sends to the monitor. If necessary, other instruments can be inserted to repair any damage or remove material that may be interfering with movement or causing pain in the shoulder.
The surgeon will look around the entire joint to check the cartilage, tendons, and ligaments of the shoulder. If damaged tissues need to be repaired, the surgeon will make 1 to 3 additional small incisions to insert other instruments. These may include a blunt hook to pull on tissues, a shaver to remove damaged or unwanted tissues, and a burr to remove bone. In addition to working on the shoulder joint, the surgeon often places the camera in the space above the rotator cuff tendons (the subacromial space). The surgeon can evaluate the area above the rotator cuff, clean out inflamed or damaged tissue, remove a bone spur, and fix a rotator cuff tear.
At the end of the procedure, the fluid is drained out of the joint and any cuts are closed. Dressings will be used to cover the cuts.

Rotator Cuff Tear

The rotator cuff or rotor cuff is the group of muscles and their tendons that act to stabilize the shoulder. Repetitive activities and overuse can injure tendons and lead to pain and impaired function. This is called Tendinitis or Tendinopathy. Tendinitis is a common problem that is more likely to occur as people age and in people who routinely perform activities that require repetitive movement that increase stress on susceptible tendons. Rotator cuff tear; the rotator cuff tendon(s) may be torn as a result of injury, chronic Tendinopathy, or a combination of both.
Common signs and symptoms of a rotator cuff tear include:

• Recurrent, constant pain, particularly with overhead activities
• Pain at night that prevents you from sleeping on the affected side
• Muscle weakness, especially when lifting the arm
• Catching, grating or cracking sounds when the arm is moved
• Rotator Cuff surgery repairs torn tendons vital to the mobility, strength and stability of the shoulder. When an acute injury occurs, the rotator cuff should be operated upon within a few weeks to ensure the success of the surgery.

Pocedure
The need to surgically repair a torn rotator cuff depends upon your age, activity level, and the severity of your tear. Surgical repair is usually recommended for people with a complete rotator cuff tear, especially if the person is young and/or active.
There are several surgical options to treat rotator cuff tears, depending on the size, depth, and location of the tear. If other problems with the shoulder are discovered during the surgery, they will be corrected as well.

• Arthroscopy, in which miniature instruments are inserted into small incisions, can be used to remove bone spurs or inflammatory portions of muscle and to repair lesser tears.
• A mini-open repair that combines arthroscopy and a small incision can be used to treat full-thickness tears.
• In more severe cases, open surgery is required to repair the injured tendon. Sometimes a tissue transfer or a tendon graft is used.

Bankart Repair

Bankart Repair surgically treats torn ligament tissue in the lower, front part of the shoulder. Shoulder dislocation often causes a Bankart lesion, or tearing of the inferior glenohumeral ligament part of the labrum. The labrum is a ring of fibrous cartilage that lines the bone socket of the shoulder, known as the glenoid. The labrum deepens the socket and adds stability to the shoulder. A Bankart lesion significantly weakens the shoulder.
Common signs and symptoms include:

• Weakness in the shoulder when lifting, throwing or reaching overhead
• Rotational instability
• Pain in the shoulder with movement, especially overhead motions
• Aching sensations
• The shoulder locking up or needing to pop

Pocedure
Arthroscopic Bankart Repair is a relatively new procedure that uses three or four smaller incisions. The arthroscopic procedure takes longer but has a shorter postoperative recovery time. Factors such as age, physical activity, and the extent of damage are taken into account before deciding which procedure is best for each patient.
Once the anaesthesia has taken effect, small cuts (about 5mm long) are made in the skin around the shoulder that is being treated. Sterile fluid is injected into the joint to help produce a clearer picture. The arthroscope is inserted through one of these cuts into the joint.
The surgeon will look around the entire joint to check the cartilage, tendons, and ligaments of the shoulder. If damaged tissues need to be repaired, the surgeon will make 1 to 3 additional small incisions to insert other instruments. These may include a blunt hook to pull on tissues, a shaver to remove damaged or unwanted tissues, and a burr to remove bone. The surgeon will attach sutures to dissolvable anchors and securely fix the anchors to the glenoid. The surgeon will then run the sutures through the labrum and securely fasten it to the glenoid, thereby fixing the Bankart lesion.