Common problems either treated or assisted by arthroscopy in shoulder joint:
Recurrent shoulder dislocation, joint coming out of place
Shoulder dislocation is usually caused by an injury. A traumatic shoulder dislocation, especially in the younger patients, tends to become recurrent due to a failure of the torn ligament (IGHL) and labrum to heal at the correct anatomical location.
With repeated dislocations, the extent of damage to the bone (Humerus-Hill Sachs lesion, glenoid bone loss) as well as the soft tissues (Bankart lesion, ALPSA lesion) increases.
MRI scan and CT scan can usually give a fairly good idea about the extent of damage suffered and helps in planning the surgery.
In patients with a preserved bone stock and good quality soft tissues, arthroscopic labral repair (Bankart repair, ALPSA repair) will give excellent results.
After the repair, patients are able to get back to leading an active lifestyle including participating in sports.
SLAP or superior labrum anterior posterior detachments are seen more often in overhead athletes. They are generally caused either by a traction injury to the arm or a fall on an outstretched hand.
They usually present with a dull aching pain in the upper arm along with a weakness in throwing or overhead activities.
Various types (more than 7 types) have been described and most of the symptomatic patients need arthroscopic repair of SLAP for recovery and function.
Rotator cuff tears
The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor and subscapularis) which encompass the shoulder from three sides, top, front and back.
They are responsible for fine tuning the movements of the shoulder joint, especially so in overhead functioning.
A full thickness traumatic tear of the cuff results in pain and inability or difficulty in raising the arm overhead.
A partial thickness cuff tear might present with pain and a decrease in the strength of the shoulder.
Rotator cuff tears can be repaired arthroscopically with a predictably good recovery on most occasions.
Stiff (Frozen) shoulder
This is a condition where there is active as well as passive loss of movement in many directions.
In the early stages, pain, as well as stiffness, is the primary features. Eventually the pain may settle; however, very often the stiffness persists.
This generally affects people over the age of 50years and is quite common in diabetics.
The arthroscopic release might be indicated in those patients who do not respond to conservative management.
This is the situation where there is a bony outgrowth from the undersurface of acromion or anomalous acromion type 3 causing crowding and irritation of rotator cuff, resulting in pain and stiffness in the shoulder.
This can be settled with arthroscopic subacromial decompression and acromioplasty means shaving off that extra bone with motorized shavers and radio frequency device(RF).