Shoulder Arthroscopy Overview
Physicians and laypeople alike have worked to repair broken bones and straighten those distorted from birth for millennia. However, orthopaedics was only established as the province of a formally trained surgeon during the late 19th century. Most of the subsequent advances in this field remained focused on improving the treatment of fractures and spinal deformities. Nevertheless, some more adventurous surgeons began exploring other options, eventually developing radically new possibilities, such as joint repairs and shoulder arthroscopy.
Today, these procedures are performed routinely and with great success by those surgeons who possess the necessary skills. However, a Japanese professor, Kenji Takagi, became the first to use a modified cystoscope to explore the internal structure of a cadaver knee joint. His efforts led to this revolution in orthopaedic practices. While the X-ray machine was a valuable diagnostic, it could not provide the soft-tissue detail possible with this new device. Following its initial use as a practical means to explore joint anatomy and identify pathologies, shoulder arthroscopy and similar procedures applied to other joints have been adapted for therapeutic purposes.
An orthopaedic surgeon would have once needed to perform open surgery to treat impingement syndrome or repair a torn rotator cuff. However, when guided by the video images captured by an arthroscope, it is possible to treat these and numerous other joint problems using just two or three tiny incisions. The minimally invasive technique can offer several advantages for the patient. Firstly, the method reduces the risk of excessive bleeding and infection. Also, post-operative recovery times are significantly shorter among patients undergoing shoulder arthroscopy than those who receive open joint surgery.
Often, the diagnostic and therapeutic stages can be combined. Having made the first incision to insert the scope and determine the extent of any damage, the surgeon can decide on the best course of action and proceed with the surgery. It will only be necessary to make the additional keyhole incisions required to insert the required surgical instruments.
Apart from its use in treating impingement syndrome and tears to the rotator cuff, shoulder arthroscopy has many other surgical applications. For example, it offers a minimally invasive approach when performing a SLAP repair, the name given to the process of reattaching a damaged labrum to the glenoid socket in the scapula. The technique can also be used to repair a biceps tendon, treat recurrent dislocations, and even replace damaged components of the joint with prostheses.
The orthopaedic unit of the Life Wilgers Hospital in Pretoria specialises in minimally invasive surgery. Under the leadership of Dr Jan De Vos, the department has become a national and international referral destination for patients requiring hip, knee, or shoulder arthroscopy.