Shoulder joint pain is commonly found in working-age adults and the elderly, especially in those who use their shoulders heavily, such as athletes, people who regularly lift heavy objects, or those who repeatedly use their shoulders for long periods at work. Chronic shoulder pain or difficulty moving the shoulder may be a sign of an internal shoulder joint disorder that requires treatment.
In cases where patients have been treated with various methods such as rest, medication, injections, or physical therapy but symptoms do not improve within 3-6 months, doctors may consider shoulder arthroscopic surgery. Currently, arthroscopic shoulder surgery technology helps reduce tissue damage from open surgery and allows patients to recover faster.
What symptoms indicate that “arthroscopic shoulder surgery” might be considered?
When other treatments are ineffective, arthroscopic shoulder surgery may be an appropriate option for patients with the following symptoms:
- Chronic shoulder pain that interferes with daily life, often related to inflammation or damage to the tendons around the shoulder joint (Rotator Cuff). If there is a tendon tear, pain is usually accompanied by arm weakness, especially when lifting or rotating the arm.
- Inability to lift the arm or limited shoulder movement, such as difficulty putting on clothes or reaching for objects. This may be caused by frozen shoulder, which results from inflammation and thickening of the shoulder joint capsule.
- Repeated shoulder dislocation or feeling of instability, indicating damage to the tendons or joint capsule that holds the shoulder in the socket. Without treatment, the shoulder may dislocate repeatedly.
- Clicking sounds or catching sensations during movement, which may be caused by worn cartilage, loose bone fragments, or cartilage floating in the joint, leading to friction.
- Previous shoulder injury with persistent symptoms after rest or physical therapy, such as fractures, cartilage wear, or tendon tears that cannot heal on their own, may require surgery to restore the internal joint structure.
Doctors will perform a thorough diagnosis by physical examination and using various tools such as X-rays, ultrasound, or MRI to assess the severity of symptoms and plan appropriate treatment.
Understanding arthroscopic shoulder surgery: the procedure and reducing concerns. Arthroscopic shoulder surgery is a treatment method that uses a small camera and specialized surgical instruments inserted through small incisions around the shoulder to repair or correct abnormalities inside the joint without the need for large open incisions as in traditional surgery.
The surgical procedure is as follows:
- The doctor will administer local anesthesia combined with general anesthesia depending on the suitability for each patient to ensure the patient does not feel pain during surgery.
- The doctor will make small incisions about 0.5-1 centimeters in 2-4 locations around the shoulder, depending on the complexity of the condition and the instruments used.
- Insert a small camera along with special instruments into the shoulder area to repair damage such as suturing torn tendons, correcting shoulder dislocation, or removing abnormal bone and cartilage fragments. The camera sends images to a monitor, allowing the doctor to see the shoulder joint structure clearly and perform precise surgery.
- After the surgery is completed, the doctor will close the incisions and bandage the wounds to prevent infection.
- The surgery takes about 1-2 hours. If multiple repairs are needed or the patient has recurrent shoulder dislocations, the surgery may take longer.
- Most patients can go home the same day after surgery or stay in the hospital for one night.
Advantages of arthroscopic shoulder surgery
Arthroscopic shoulder surgery has several advantages compared to open surgery, such as:
- Very small incisions of only 0.5-1 centimeters, which reduce scarring and significantly decrease postoperative pain.
- Reduced blood loss, risk of infection, and injury to surrounding tissues because it is a minimally invasive surgery. It also offers high precision due to technology that allows doctors to clearly see the internal joint details, increasing the success rate of the surgery.
- Faster recovery. Patients can walk and perform light activities sooner than with open surgery, allowing a quicker return to daily life and reducing hospital stays and costs.
- Suitable for many patient groups, including athletes, working adults, and the elderly, especially those with shoulder joint abnormalities such as rotator cuff tears where the tissue quality is still sufficient for repair.
Limitations of arthroscopic shoulder surgery
Although arthroscopic shoulder surgery reduces injury and speeds recovery, there are some limitations where this method is not suitable, such as:
- Not suitable for patients with severe or chronic tendon tears involving multiple muscles or multiple sites, with severe muscle atrophy.
- Patients with severe shoulder osteoarthritis or extensively damaged joints, such as destroyed cartilage or severely altered joint structures.
- Complex or large internal shoulder joint damage beyond the scope that arthroscopic instruments can effectively repair.
Patients with these conditions may require open surgery or shoulder replacement surgery instead.
Risks and complications that may occur after surgery
Although arthroscopic shoulder surgery is a highly safe procedure that helps patients recover quickly, there are some risks to watch for and follow the doctor’s instructions carefully, including:
- Inflammation and swelling from tissue injury around the area, which usually improves within 1-2 weeks or can be managed with pain medication and cold compresses.
- Infection at the surgical wound or inside the joint if the wound is not clean or the patient has low immunity. If there is swelling, redness, heat, pus at the wound, or severe shoulder pain, see a doctor immediately.
- Nerve compression or injury causing numbness, weakness, or abnormal pain in the arm and hand. Most cases improve on their own, but some may require additional treatment.
- Bleeding in the surgical area from damaged small blood vessels, causing increased swelling and pain. Severe bleeding may require drainage or repeat surgery.
- Frozen shoulder caused by scar tissue, leading to reduced shoulder movement and pain. Continuous physical therapy reduces the chance of this condition.
- Respiratory, cardiac, or allergic reactions in some cases from anesthesia. There is also a risk of blood clots after surgery, especially in the elderly or those with underlying diseases.
Self-care after surgery for rapid recovery
After arthroscopic shoulder surgery, proper self-care helps ensure effective recovery, with the following guidelines:
- Support the shoulder using a sling to support the shoulder during the first 1-3 weeks to allow tendons, tissues, and muscles to heal and avoid excessive movement.
- Take pain medication to relieve pain and reduce inflammation.
- Keep the wound dry and clean until it is fully closed to prevent infection.
- Undergo physical therapy to prevent frozen shoulder and help regain full function faster. Doctors or physical therapists will design a suitable program for each patient, including supported shoulder movements to reduce pressure, strengthening, and flexibility exercises to increase the range of motion such as lifting, rotating, and extending the arm.
- Follow up with the doctor as scheduled to assess wound healing, shoulder recovery, and adjust treatment or physical therapy plans as needed.
If you are experiencing chronic shoulder pain, painful shoulder movement, or feel shoulder stiffness, arthroscopic shoulder surgery may be an option to help restore normal movement. At Phyathai Phaholyothin Hospital, we have a specialized team of shoulder surgeons and surgical technology ready to provide comprehensive services from detailed assessment, precise surgery, to postoperative rehabilitation, helping you regain confidence and move freely again.
Dr. Worawit Ungbamrungphan
Orthopedic Surgeon, Sports Medicine Specialist
Phyathai Phaholyothin Hospital
