Your surgeon will explain how to prepare for your procedure. If you smoke, for example, you will be asked to stop. Smoking increases your risk of getting a chest or wound infection, which can slow down your recovery. It can also make your surgery less effective and lead to complications.
Shoulder arthroscopy is usually done as a day-case procedure in a hospital. This means you have the procedure and go home on the same day.
You will usually have a shoulder arthroscopy under general anaesthesia. If you have a general anaesthetic, you’ll be asleep during the operation. Sometimes, your surgeon may use a combination of both local and general anaesthetics. Local anaesthesia completely stops you feeling any pain in your shoulder area. Occasionally, you may be able to have the whole operation under a local anaesthesia. This means you will stay awake during surgery. Your surgeon may offer you a sedative with the local anaesthetic. This relieves anxiety, makes you feel sleepy and helps you to relax during the operation.
If you're having a general anaesthetic, you’ll be asked to follow fasting instructions. This means not eating or drinking anything, usually for about six hours, before your surgery. It’s important to follow your anaesthetist’s advice.
You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anticlotting medicine called heparin as well as, or instead of, wearing compression stockings.
Your nurse or surgeon will discuss with you what will happen before, during and after your procedure, including any pain you might have. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed so you feel happy to give your consent for the procedure to go ahead. You may be asked to do this by signing a consent form.
Not everyone who has a problem with their shoulder will need to have an arthroscopy. Your doctor will usually be able to diagnose your shoulder problem by examining you. You may also need to have some imaging tests, such as an X-ray, an ultrasound or an MRI scan.
The best treatment for your shoulder problem will depend on what’s caused the damage. Sometimes, your symptoms will improve on their own without treatment. Your doctor may suggest you try some self-help measures, such as doing exercises to strengthen the muscles around your shoulder. Other treatments for shoulder problems include physiotherapy and corticosteroid injections. Talk to your doctor about which treatment options are the right ones for you.
A shoulder arthroscopy often takes less than an hour. The length of your procedure will depend on how much work your surgeon needs to do inside your shoulder joint. You may have the surgery sitting in a deckchair position or lying on your side.
Once the anaesthetic has taken effect, your surgeon will make small cuts in the skin around your shoulder joint. They will then insert the arthroscope. This is like a tiny camera that your surgeon can use to view inside your shoulder joint.
Your surgeon will examine your shoulder joint by looking at images sent by the arthroscope to a monitor. If there’s any damage in your shoulder, they will insert surgical instruments to repair it. Your surgeon will also remove any damaged tissue that stops you moving your shoulder properly and causes pain.
Afterwards, your surgeon will close the cuts with stitches or adhesive strips. They will then wrap a dressing and a bandage around your shoulder.
It’s possible that your surgeon may need to change to open surgery during the procedure. This might be if they need to make a larger cut to repair a larger muscle tear. Your surgeon will talk to you about this risk before you consent to the procedure.
You may need to rest until the effects of the anaesthetic have worn off. After a local anaesthetic, it may be several hours before the feeling comes back into your shoulder. Take special care not to bump or knock the area. You may have some discomfort as the anaesthetic wears off. You’ll be offered pain relief as you need it.
You will usually be able to go home when you feel ready. You'll need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after your shoulder arthroscopy.
Having a general anaesthesic or sedative affects everyone differently. You may find that you’re not so coordinated or that it’s difficult to think clearly. This should pass within 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or sign anything important. Always follow your surgeon’s advice.
Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment.
It will take a while for your dissolvable stitches to disappear. How long will depend on the type of stitches you have and how quickly your wound heals.
Your shoulder joint is likely to feel sore and stiff after surgery. Try to rest your arm. Applying a cold compress such as an ice pack or a bag of frozen peas wrapped in a towel may help to reduce swelling and bruising. But don’t apply ice directly to your bare shoulder as it can damage your skin.
You may need to keep your arm in a sling after the operation. This will keep your shoulder in the right position to recover properly and will reduce any pain and swelling. The sling will also protect your shoulder from further damage until it’s fully recovered. Your surgeon will tell you how long you will need to wear a sling for.
You may struggle to dress and wash yourself at first – you may want to ask your partner, a relative or friend to be on hand to help you.. The first few weeks will be the most difficult – it should start to get eaisier after this.
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist for advice.
Your physiotherapist will recommend some exercises for you. Doing these regularly will help your shoulder to heal and may help you to recover more quickly.
It usually takes several weeks to make a full recovery from shoulder arthroscopy. Most people get the full movement of their shoulder back afterwards, but this can take several months. Your recovery time will depend on what treatment if any, your surgeon performs on your shoulder joint. It will also make a difference how severe your shoulder problem is and how fit you are. It's important to follow your surgeon's advice.
You can usually drive once you’re fully mobile, but check with your doctor and motor insurance company first.
After having a shoulder arthroscopy, you may get some unwanted side-effects, which are mostly temporary.
You may have small scars on your shoulder from the cuts made by your surgeon. Your shoulder and arm may be painful or uncomfortable for several weeks. You may also have some pain and stiffness around your shoulder.
Complications are when problems occur during or after a procedure. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in your leg (called deep vein thrombosis, DVT).
Specific complications of arthroscopy include:
- accidental damage to the inside of your joint
- an infection
- excessive bleeding into your joint
- damage to surrounding blood vessels or nerves
It's possible that the procedure won't work and you may need to have it again. This is more likely to happen if you smoke.
Remember – all medical procedures come with some risks. How these risks apply to you will be different from how they apply to others. Be sure to ask for more information if you have any concerns.
It’s a good idea to be as fit and healthy as possible before your operation. It’s also important to follow your surgeon’s advice about your recovery.
If you smoke, you will be asked to stop before your operation. Smoking can slow down your recovery because it increases your risk of getting a chest or wound infection. Smoking can also increase the risk that the shoulder arthroscopy won’t work and that you’ll need to have the surgery again. Your surgeon may recommend losing excess weight before you have your operation if you’re overweight.
Remember to do the exercises your surgeon or physiotherapist shows you after your operation, to improve the strength and movement of your shoulder. This may help to speed up your recovery and help you to return to work and get back to normal activities more quickly. Speak to your physiotherapist if you have any concerns.
It’s important to follow your surgeon’s advice about your recovery.
Is shoulder arthroscopy better for me than open surgery? Is shoulder arthroscopy better for me than open surgery?
Arthroscopic surgery is sometimes better than open surgery. This is because you may have less pain and need to spend less time in hospital than you would with open surgery.
The arthroscope and the surgical instruments used in a shoulder arthroscopy are very thin. This means your surgeon can make small cuts in your shoulder rather than a large cut that’s needed for open surgery. Any scars from arthroscopic surgery should be very small. An arthroscopy is also a much quicker procedure than open surgery.
You should have less pain and stiffness after an arthroscopy, compared with open surgery. You should also recover more quickly afterwards.
How much time will I have to spend off work? How much time will I have to spend off work after having shoulder arthroscopy?
It may take you several weeks or months to make a full recovery after shoulder arthroscopy. However, this varies from person to person and depends on the type of work that you do.
You can usually go home on the day of your surgery. Your recovery time will depend on what, if any, treatment your surgeon performs on your shoulder joint. Recovery may vary from a few days to several weeks depending on the severity of your shoulder problems and your level of fitness.
It’s important to remember that everyone is different – some people may need to rest for longer whereas others may return to work a few days after shoulder arthroscopy. The fitter you are before your surgery, the more quickly you’re likely to recover afterwards.
Continue to do any exercises that your surgeon and physiotherapist have given you. These exercises are important to help you get back to work and make a full recovery.
- British Orthopaedic Association
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