Arthroscopic Shoulder Surgery
An arthroscopic shoulder surgery is used to treat the orthopedic condition which results in the shoulder becoming painful and stiff. If left untreated this condition may worsen and eventually cause disability in the affected shoulder. This is a minimally invasive surgical treatment for restoring movement in a shoulder joint affected with frozen shoulder syndrome.
This condition is also known as ‘frozen shoulder’. The shoulder joint consists of the ball end of the humerus (upper arm bone) and the socket part of the scapula (shoulder blade) and the clavicle (collar bone). The head of the humerus fits in the socket part of the scapula and acts as a joint that helps the shoulder to move in a rotational motion. Certain factors care known to affect the band of connective tissues that hold the shoulder joint in place and also provide stability and support to the shoulder and causes these bands to thicken and become hardened. This also affects the amount of synovial fluid being produced in the joint for its lubrication and results in stiffness in the joint.
Frozen Shoulder syndrome
The shoulder joint is one of the main joints in the body and is most useful in helping to move the arm in various directions. The shoulder joint consists of the upper ball-shaped end of the humerus (upper arm bone) which fits into the socket-shaped portion of the scapula (shoulder blade) and also the supporting clavicle (collar bone). These bones are held in position and supported in their movements by a band of strong connective tissues called the ‘shoulder capsule’ that surrounds the joint. The body produces a slick fluid known as the ‘synovial fluid’ in the shoulder blade that helps to lubricate the components of the joint and help in their smooth movements.
A frozen shoulder causes the band of connective tissues to thicken and become stiff which is called ‘adhesions’. Many a times the lubricating synovial fluid also decreases in the joint and causes friction between the joint bones. This condition results in total disability in the shoulder joint to move on its own.
Causes for Frozen Shoulder
Although the exact reason for developing a frozen shoulder is not unknown a few factors are recognized as being related to the development of a frozen shoulder in a person, such as:
- Diabetes – People affected with diabetes are more likely to be affected with a frozen shoulder syndrome.
- Other disorders – Certain medical conditions and disorders are known to increase the risk of frozen shoulder, such as hyperthyroidism, hypothyroidism, cardiac diseases and Parkinson’s disease.
- Immobilization – In case your shoulder has been immobilized due to an injury or a surgery for a long period of time the shoulder can suffer from a frozen shoulder syndrome.
Signs and Symptoms of Frozen Shoulder
The main sign of a frozen shoulder is dull aching felt initially which gets worse with forced use of the shoulder as well as excessive use of the shoulder joint. The pain gets worse with time and the shoulder joint starts becoming stiff and is unable to move on its own. The pain felt in this condition is located on the outer shoulder area and, sometimes, in the upper arm.
Diagnosing Frozen Shoulder
The diagnosis of a frozen shoulder syndrome usually involves:
- Physical Examination – After having a look at your medical history the doctor will perform a complete physical examination of your shoulder. The doctor will try and move your affected shoulder carefully in every direction to see where the movement is limited as well as is painful.
- Imaging tests – Several imaging tests can also help to determine the exact location and the severity of the damage to the connective tissue band. Diagnostic imaging tests such as x-rays can detect the dense mass of bones and show the presence of any other bone disorders as well as MRI (magnetic resonance imaging) test and ultrasound to study the soft tissues in better detail.
In case these tests help determine the presence of frozen shoulder syndrome the doctor will then evaluate your individual case and suggest the best and most efficient form of treatment.
Frozen Shoulder Treatments
Although frozen shoulders are known to heal on their own it takes around 2-3 years of pain and disability to achieve it. There are various methods of treating a frozen shoulder that aim to improve the shoulder’s range of motion as well as to relieve the pain being caused by the affected shoulder.
Almost all of the cases of frozen shoulders are successfully treated using non-surgical treatment methods that help to significantly improve the range of motion as well as providing relief from the constant pain. The various methods used in non-surgical treatment of frozen shoulder are:
- NSAIDs – Non-steroidal anti-inflammatory drugs are helpful in reducing the swelling as well as the pain.
- Steroid injections – Powerful anti-inflammatory medicines derived from steroids can be injected into the shoulder to reduce the swelling and to decrease the pain.
- Physical therapy – Specific exercises are advised in this treatment method to restore the lost range of motion as well as to provide relief from the intense pain.
If your frozen shoulder syndrome cannot be treated successfully using the various non-surgical methods then the doctor/surgeon will advise a surgical treatment for it. Nowadays, the surgery is not performed using the conventional open-type surgery method but uses the more efficient and advantageous minimally invasive arthroscopic technique. This involves making very few (2-3) incisions of smaller (keyhole) size and using thin and flexible tubes to insert into these tiny incisions. These surgical tubes (arthroscope) are attached mainly with a cold light-source and a video camera as well as special miniaturized surgical instruments that are required to perform the surgical procedure.
The surgery requires the administering of general anesthesia in order to avoid any discomfort or pain to you during the surgical procedure. The orthopedic surgeon will make very small incisions around the affected shoulder joint. One of these incisions will be used to insert the arthroscope attached with the video camera initially. The camera allows the surgeon to get a clear and real-time detailed view of the affected joint.
The surgeon will then use a set of special miniaturized surgical instruments in order to manipulate the affected shoulder joint tissue and stretch it to increase its limit of motion. In case the soft tissue band cannot be stretched the surgeon will simply cut the stiffened tissue (shoulder capsule) in order to allow for maximum range of motion in the shoulder.
After having satisfied that the operated shoulder will be able to move freely and normally, the surgeon will remove all the instruments from the incisions in the shoulder and use very fine sutures to stitch the incision closed.
Arthroscopic shoulder surgery is one of the most popular surgical treatment methods for treating a case of frozen shoulder that is severe in nature, or, if the other methods of treatment have failed to successfully treat the condition.