Shoulder Arthroscopy – The Procedure and When it May be Necessary
Whether performed on the hip, the knee, or the shoulder, arthroscopy is a medical term derived from the merger of two Greek words, “arthron” and “skopion”, meaning “joint” and “to look at” respectively. The term “endoscope” is a generic catchall that applies to any instrument used to directly view the interior structure of a body cavity or, in this case, one of its larger, more accessible joints. In addition, each instrument also has a more specific name that relates to its purpose. Hence, the arthroscope is an instrument employed by an orthopaedic surgeon.
The procedure was and is still used mainly to examine hips and knees, but shoulder arthroscopy has been gaining ground. An X-ray offers a surgeon or physician a reliable non-invasive means to view details of radio-opaque tissues like bone and cartilage in reasonable detail. However, radiography is somewhat less helpful when looking for evidence of damage to the surrounding soft tissues, such as muscle, tendons, and ligaments – damage that might indicate disease activity or an injury.
The instrument used for this procedure today consists of a flexible tube containing a fibre optic cable that conveys light to the examination site and images to a miniature video camera during shoulder arthroscopy and examinations of other joints. A single keyhole incision is sufficient to accommodate the scope for diagnostic purposes. However, the resulting magnified, full-colour images are not the most significant advantage of this technique. When the preliminary visual examination reveals a problem and a suitable surgical solution, the surgeon now has the option to proceed directly from the diagnostic stage to perform the necessary surgical intervention in a single combined procedure. Two more keyhole incisions provide access for the instruments, and a monitor screen allows surgeons to track their actions.
Today, shoulder arthroscopy frequently offers patients a welcome alternative to the more traumatic option of undergoing open surgery when it will be necessary to expose the entire joint, which carries an increased risk of infection and excessive blood loss. By contrast, the arthroscopic approach is minimally invasive, leaving patients less prone to such risks. Furthermore, the newer procedure also means postoperative recovery times are significantly shorter.
Several conditions that would once have required open surgery are now routinely treated using shoulder arthroscopy. These include rotator cuff injuries; a torn or damaged labrum, ligament, or biceps tendon; impingement syndrome; and joint instabilities responsible for frequent dislocations, to name just a few. We are a world-class orthopaedic team at the Life Wilgers Hospital in Pretoria that routinely undertakes these and similar procedures on the knee and hip joint.