Name of the Procedure:

Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)

Summary

Arthroscopy of the shoulder is a minimally invasive surgical procedure used to examine and diagnose problems inside the shoulder joint. A small camera (arthroscope) is inserted through tiny incisions to provide a clear view of the joint. Sometimes a biopsy of the synovial tissue is taken during this procedure.

Purpose

This procedure is performed to diagnose shoulder joint issues such as arthritis, torn cartilage, labral tears, or ligament injuries. The goal is to accurately identify the cause of shoulder pain or dysfunction and to collect tissue samples if needed.

Indications

• Persistent shoulder pain
• Limited range of motion
• Suspected rotator cuff tears
• Joint instability
• Unexplained swelling or synovitis
• Conditions unresponsive to conservative treatments

Preparation

• Fasting for at least 6-8 hours before the procedure
• Adjustments to regular medications, as advised by the doctor
• Pre-procedure imaging tests such as X-rays or MRI
• Blood tests to ensure proper clotting and overall health

Procedure Description

1. The patient is given regional anesthesia or general anesthesia.
2. Small incisions are made around the shoulder joint.
3. A sterile saline solution is injected to expand the joint space.
4. An arthroscope is inserted into one of the incisions to visualize the joint.
5. Additional instruments may be used through other incisions to probe, palpate, or take tissue samples (biopsy if required).
6. Findings are documented, and the arthroscope is removed.
7. Incisions are closed with sutures or sterile strips.

Duration

The procedure typically takes 30 minutes to an hour.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Infection at the incision site
• Bleeding or deep vein thrombosis
• Damage to surrounding tissues or nerves
• Joint stiffness or decreased range of motion
• Allergic reactions to anesthesia
• Persistent pain

Benefits

• Accurate diagnosis of shoulder conditions
• Minimally invasive with smaller incisions and quicker recovery compared to open surgery
• Relief from symptoms shortly after diagnosis and treatment

Recovery

• Post-procedure monitoring for a few hours
• Pain management with prescribed medications
• Instructions on shoulder immobilization and gentle exercises
• Usually, a follow-up appointment within a week
• Full recovery may take several weeks, with physical therapy recommended for optimal outcome

Alternatives

• Non-invasive imaging techniques (MRI, CT scan) for diagnosis
• Conservative treatments like physical therapy, medications, or injections
• Open shoulder surgery for more complex or extensive issues

Patient Experience

• Temporary discomfort at the incision sites
• Mild soreness and swelling around the shoulder joint
• Pain management through prescribed medications and ice application
• Gradual improvement in symptoms and shoulder function with adherence to postoperative care instructions and physical therapy.