Shoulder Arthroscopy

Shoulder arthroscopy is keyhole surgery on the shoulder. Your surgeon passes a pencil-sized camera into the joint through a small puncture in the skin, and works through two or three further punctures of around five millimetres each using fine instruments. The joint is filled with sterile fluid under pressure, which opens the space and keeps the view clear.

The camera shows the joint surfaces, the ring of cartilage around the socket, the tendons and the ligaments directly and at magnification, so the inspection is part of the operation. Your surgeon often confirms exactly what is wrong at this point, and the plan agreed before surgery can be adjusted to what is found.

Repairs are made with anchors, which are small implants set into the bone carrying strong sutures used to hold soft tissue back against it. Bone can be trimmed, inflamed tissue removed and scarred tissue released through the same portals. The small incisions mean less pain in the first days and a lower rate of wound problems than open surgery, and they do not change how long the tissue inside takes to heal, which is the part that sets your timeline.

The operation is done under a general anaesthetic, usually combined with a nerve block that numbs the arm for the first twelve to twenty-four hours. You will be positioned either sitting up in a beach-chair position or on your side with the arm held in traction, and both are routine.

Your surgeon marks and makes the portals, inserts the camera, inspects the joint and the space above it, then carries out the planned work through the other portals. A simple procedure takes around forty-five minutes; a repair takes ninety minutes or more. The portals are closed with a stitch or two each and covered with small dressings.

You are admitted for the day and usually stay one night, though some straightforward cases go home the same evening once they are awake, eating and comfortable. You leave in a sling with painkillers, instructions on when to start moving, and a physiotherapy appointment. The arm feels completely dead until the block wears off, and the pain arrives fairly suddenly when it does, so take the painkillers before that happens instead of waiting.

How long you wear the sling depends entirely on whether anything was repaired. Where tissue was trimmed or released, the sling is for comfort only and comes off within a few days. Where a tendon or the cartilage ring was repaired back to bone, the sling stays on for four to six weeks and the restrictions are strict, since the repair holds by the healing of tissue to bone and not by the stitches.

The small wounds are healed in ten to fourteen days. Expect the shoulder to be sore at night for two to three weeks, and expect to sleep propped up during that time.

Desk work is possible within one to two weeks for most people. Driving comes after the sling is finished and you can control the wheel, which is one to two weeks after a simple procedure and around six weeks after a repair. Return to gym work, throwing and contact sport is staged by your physiotherapist and is commonly three months after a simple procedure and four to six months after a repair.