The diagnosis and treatment of shoulder joint problems have improved greatly since a minimally invasive procedure called arthroscopy was developed. Arthroscopy allows your surgeon to see inside your shoulder and to carry out procedures through tiny incisions.

Arthroscopic surgery can be used to diagnose and treat shoulder injuries.

Arthroscopy uses a device called an arthroscope. This tiny, pen-shaped instrument has a micro video camera attached to the end. The arthroscope is inserted through a tiny incision in your shoulder. The camera relays images to a computer screen. Your surgeon can use the images to diagnose the joint problem and to carry out appropriate surgery.

During the surgery, several tiny incisions are made to insert the arthroscope and surgical instruments. First, the surgeon uses the arthroscope to view the shoulder and evaluate the bones, tendons (def.)Tendons Tendons are cord-like structures made of collagen that connect muscles to bones., and ligaments (def.)Ligaments Ligaments are thick fibrous bands of tissue that link two or more bones together and frequently stabilize joints.. Then the surgeon uses small instruments to make necessary repairs.

This minimally invasive approach to surgery can help speed recovery, reduce pain, and minimize scarring, when compared with traditional "open" surgery.

• Patient Jennifer says she is pleased with the results of her arthroscopic surgery, returning to work within a week. "The surgeon did a great job and was very supportive before and after the surgery. He only did what he needed to do during the procedure. I was so happy he could do what he needed to do arthroscopically."

  Jennifer also says she is delighted that her scars are so minimal. "I had two tiny incisions — and one is almost invisible now," she pointed out.

Arthroscopic surgery may be an option for treating the following shoulder problems:

• Torn rotator cuff
• Shoulder impingement
• Shoulder dislocation/separation (instability)
• Arthritis
• Tendinitis (tendonitis) and bursitis

Your orthopaedic surgeon (def.)Orthopaedic Surgeon (Orthopaedic Specialist) orthopaedic surgeon specializes in the diagnosis and treatment of disorders of the body's bones, joints, ligaments, muscles, and tendons (musculoskeletal disorders.) can use arthroscopic surgery to perform these and other procedures:

• Remove small bits of bone or cartilage (def.)Cartilage (also, Articular Cartilage) Cartilage is the rubbery, fibrous connective tissue found between bones. It allows joints to move smoothly.
• Repair or remove torn tendons
• Remove inflamed synovium (def.)Synovium Your shoulder joints are held together by a "capsule" of tissues and ligaments. The innermost tissue of the capsule is a membrane called the synovium. (the membrane that lines the cavity of a synovial joint and produces synovial fluid (def.)Synovial Fluid Synovial fluid is a fluid produced by cells lining the joint capsule or synovium. This fluid lubricates the joint surfaces and provides cartilage with nutrients.)
• Remove inflamed bursae (def.)Bursae Bursae (singular = bursa) are filmy, sac-like structures that allow bones, muscles and tendons to glide smoothly over each other. In the shoulder, the bursae are located between the rotator cuff tendons and the shoulder blade (acromion). They help cushion the rotator cuff from the boney front edge of the shoulder blade.

Keep in mind that orthopaedic experts say many shoulder patients are seen later than recommended. Individuals who have pain that's more than just a little bruise, ache, or a muscle strain should seek early evaluation, the experts counsel.

There are potential benefits of arthroscopic surgery when compared with traditional "open" surgery. With arthroscopic surgery, it's more likely that:

• You'll have less pain following the procedure
• You'll have a lower risk of complications
• You'll have a shorter hospital stay or the procedure may be done as out-patient surgery
• You'll have a quicker recovery
• You'll have less scarring

Arthroscopic surgery and complying with your physical therapy plan can help jump-start your return to the activities you love.

All surgery has risks:

• Your orthopaedic surgeon also will discuss the specific risks associated with your procedure and recovery. The risks of orthopaedic surgery depend on your health before surgery and the type of surgery done
• Your anesthesiologist will discuss the risk associated with the use of anesthesia during your procedure

Some of the things that may be discussed include:

• Bleeding or other problems during the procedure
• Damage to joint tissues or nerves around the joint
• How your individual weight, activity level,age and other factors may affect your outcome

Possible postsurgical complications include:

• infection
• excessive swelling or bleeding
• joint stiffness
• blood clots in the leg veins (thrombophlebitis)
• leakage of blood into the joint (hemarthrosis) blood clots that travel to the lung (pulmonary embolus).