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Shoulder Arthroscopy : Procedure.pptx
- 1. SHOULDER ARTHROSCOPY PREPARED BY PENUBALA SAI DHARANI PT MSK & SPORTS
- 2. • Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and treat problems inside a joint. • During shoulder arthroscopy, surgeon inserts a small camera, called an arthroscope, into shoulder joint. The camera displays pictures on a video monitor, and surgeon uses these images to guide miniature surgical instruments. • Because the arthroscope and surgical instruments are thin, surgeon can use very small incisions (cuts), rather than the larger incisions needed for standard, open surgery. This results in less pain for patients and shortens the time it takes to recover and return to favorite activities.
- 3. ANATOMY The shoulder is a complex joint that is capable of more motion than any other joint in the human body. It is made up of three bones: • The upper arm bone (humerus) • The shoulder blade (scapula) • The collarbone (clavicle)
- 4. INDICATIONS • Rotator cuff repair • Removal or repair of the labrum • Repair of ligaments • Removal of inflamed tissue or loose cartilage • Repair for recurrent shoulder dislocation (chronic shoulder instability)
- 5. EVALUATIONS AND TESTS • Orthopaedic surgeon make sure that patient do not have any medical problems that need to be addressed before surgery. • Blood tests, an electrocardiogram, or a chest X-ray may be needed to safely perform surgery. • If patient have certain health risks, a more extensive evaluation may be necessary before surgery.
- 6. Positioning and Preparation • Once in the operating room, you will be positioned so that your surgeon can easily adjust the arthroscope to have a clear view of the inside of your shoulder. The two most common patient positions for arthroscopic shoulder surgery are: • Beach chair position. This is a semi-seated position similar to sitting in a reclining chair. • Lateral decubitus position. In this position the patient lies on their side on an operating table. • Each position has some slight advantages. Surgeons select positions based on the procedure being performed, as well as their individual training. Once you are positioned, the surgical team will: • Remove (shave) hair, if needed • Spread an antiseptic solution over your shoulder to clean the skin. • Cover your shoulder and arm with sterile drapes • Most likely place your forearm in a holding device to ensure your arm stays still during the procedure
- 7. PROCEDURE • Surgeon may inject fluid into the shoulder to inflate the joint. This makes it easier to see all the structures of shoulder through the arthroscope. • Then, surgeon will make a small puncture in your shoulder (about the size of a buttonhole) for the arthroscope. • Fluid flows through the arthroscope to keep the view clear and control any bleeding. Images from the arthroscope are projected on the video screen, showing surgeon the inside of shoulder and any damage.
- 8. • Once the problem is clearly identified, surgeon will insert other small instruments through separate incisions to treat it. Specialized instruments are used for tasks like shaving, cutting, grasping, suture passing, and knot tying. In many cases, special devices are used to anchor stitches into bone. • Once the procedure is done, your surgeon will close your incisions with either stitches or steri-strips (small Band-Aids) and cover them with a large, soft bandage.
- 9. Post-operative • After surgery, patient will stay in the recovery room for 1 to 2 hours before being discharged home. • Nurses will monitor responsiveness and provide with pain medication, if needed. AT HOME • Although recovery from arthroscopy is often faster than recovery from open surgery, it may still take weeks to months for your shoulder joint to completely recover. • You can expect some pain and discomfort for several weeks after surgery. If you have had a more extensive surgery, however, it may take longer before pain subsides. • Ice will help relieve pain and swelling.
- 10. Pain medication • Opioids • Nonsteroidal anti-inflammatory drugs (NSAIDs) • Local anaesthetics REHABILITAION • Rehabilitation plays an important role in getting you back to your daily activities. Your surgeon will develop a rehabilitation plan based on the surgical procedures you required. • An exercise program will help you regain shoulder strength and motion. If you have had a more complicated surgical repair, your surgeon may recommend a physical therapist to supervise your exercise program. • For your surgery to be a success, it is important that you make a strong effort at rehabilitation.
- 11. COMPLICATIONS Potential problems with arthroscopy include: • Infection • Excessive bleeding • Blood clots • Damage to blood vessels or nerves