Shoulder Arthroscopy in the Treatment of Injuries
Until the early 1960s, the only means for an orthopaedic surgeon to repair internal injuries to a joint was to perform an open procedure. That constraint ceased when, in 1962, Dr Masaki Watanabe became the first to employ an arthroscope to repair a torn meniscus. Although the early use of this minimally invasive technique focussed mainly on the knee and hip joints, the practice of shoulder arthroscopy has been growing steadily since the 1970s. Today, surgeons can treat most injuries to the joint in this fashion. Let’s take a closer look at this instrument and some of the conditions it can be used to treat.
What is an Arthroscope?
The arthroscope consists of a small video camera mounted on a flexible tube containing a fibre-optic cable. When a surgeon inserts the device into the joint via a keyhole-sized incision, the cable conveys light to the work area and a magnified view of the bones and soft tissues to a monitor screen. While shoulder arthroscopy is a means to make or confirm a diagnosis, it is also a means to perform keyhole surgery. Two additional tiny incisions provide portals to insert the necessary instruments, while the monitor view allows the surgeon to manipulate them. This minimally invasive technique has several benefits. It reduces the risk of infection, it requires less recovery time, and patients tend to experience less post-operative pain and stiffness than with open procedures.
Read more about the History of Arthroscopy.
Some Common Reasons to Perform this Procedure
It remains true that most arthroscopic surgery is to repair injuries to the knee. However, shoulder arthroscopy is now the second most common form of orthopaedic surgery. Injuries to this joint can take many forms, and some may respond to palliative treatments, such as physiotherapy and medication. However, surgery is invariably the next step when joint pain fails to respond to such options. X-rays and other medical imaging techniques will often be sufficient to identify the cause and help the surgeon decide how best to treat it. The minimally invasive approach offers both the means to confirm the type of injury and treat it.
One of the most common reasons for shoulder arthroscopy is to repair a damaged rotator cuff. This type of injury often affects those engaged in heavy lifting but may also be associated with ageing. Treatment can involve repairs to torn tendons or muscles but might also require removing any bony spurs that might be contributing to the damage.
Instability resulting in frequent dislocations, injuries to the biceps tendon, labral tears, osteoarthritis, and impingement syndrome are now commonly treated using minimally invasive procedures. However, shoulder arthroscopy is demanding. It is a task that requires specially trained and experienced orthopaedic surgeons like the world-renowned team at the Life Wilgers Hospital in Pretoria.