Arthroscopy is a minimally invasive surgical technique, commonly performed in sports medicine, that utilizes fiber optics to give orthopaedic surgeons a greater field of vision when operating on shoulders, hips, knees, and many other joints. Sports medicine specialists prefer arthroscopy to open surgery methods because its minimally invasive nature allows athletes to get back on the playing field faster than ever before. Commonly performed arthroscopic surgeries include, but are not limited to: ACL reconstruction, meniscus repair, and rotator cuff repair.
Shoulder arthroscopy is usually performed to treat sports injuries, such as damage to the labrum or the rotator cuff muscles located on the shoulder blade. Because the shoulder is a relatively unstable joint, it is common during high contact sports for athletes to sustain an injury. Arthroscopy allows patients to return to their previous levels of activity in a matter of weeks.
The shoulder joint is made up of the humerus (upper arm bone) and the scapula (shoulder blade). The head of the humerus connects to the glenoid, a cavity located on the scapula, to create a ball-and-socket joint with the head of the humerus fitting snuggly inside the glenoid. A piece of cartilage called the labrum lines the outside of the joint to provide stability.
A shoulder arthroscopy procedure is performed very similarly to knee arthroscopy . The surgeon incises the shoulder to insert the arthroscope, which provides a greater field of vision and additional light for the surgeon to accurately perform the procedure. After inserting the arthroscope, the surgeon performs the procedure through a second small incision. The surgeon can then remove any loose fragments of tissue or cartilage in the area and repair the affected components.
The rotator cuff is a set of muscles and tendons that cover the humerus, and allow the shoulder joint to rotate and raise the arm. Additionally, the rotator cuff provides strength and stability to the shoulder joint by attaching to the ball of the shoulder joint.
Rotator cuff tears are common sports injuries, commonly sustained through repetitive overhead motions in sports such as pitching a baseball, serving in tennis, or swinging in golf. Symptoms of rotator cuff tears include pain lifting or lowering the arm, weakness when rotating the arm, as well as a "cracking" sensation when moving the arm in certain positions.
Rotator cuff tears are typically treated arthroscopoically, in which the surgeon is able to see and operate within the joint without making a large incision. In an arthroscopic shoulder surgery, the orthopaedic surgeon will make a small incision to insert an arthroscope, a fiber-optic camera that sends video imaging from within the shoulder joint to a computer monitor. In a second incision, the surgeon will insert the operating instruments, roughly the size of pencils, to perform the operation.
Because arthroscopic surgery is minimally invasive by nature, the surgical procedure has benefits beyond traditional open surgery, such as reduced blood loss, quicker rate of recovery, and minimized scarring. Athletes undergoing arthroscopic shoulder surgery for rotator cuff repair often heal within four to six weeks.
Dr. Haar specializes in a variety of orthopaedic conditions, and is considered an arthroscopic specialist by his peers in the New York City region. When surgery is indicated for patients who cannot be treated through conservative treatment methods, such as physical therapy or an anti-inflammatory medication regimen, Dr. Haar prefers minimally invasive surgical techniques.
Find out more about Dr. Haar's Upper East Side office to schedule an appointment for a comprehensive consultation
Shoulder arthroscopy is a surgical technique that shoulder surgeons in New York use very frequently to treat shoulder injuries. Arthroscopy allows you to see the inside of the shoulder joint through small, pointed incisions, on a TV screen. It helps in making a more accurate diagnosis of the problem. Furthermore, this surgical treatment can be applied directly since most of the shoulder structures are accessible arthroscopically.
Shoulder arthroscopy is a minimally invasive surgical technique, but it allows the doctor to access the two compartments that make up the shoulder joint: the glenohumeral joint and the subacromial joint. As the procedure is not very aggressive, the postoperative period is less painful for the patient and allows an early home transfer. It is usually done under general anesthesia, but it can also be done with regional anesthesia and sedation.
The arthroscopic technique is highly recommended in a majority of cases as it is both safe and comfortable for the patient. The duration of the procedure depends on the type of shoulder injury and the repair to be performed, but typically lasts between 30 and 90 minutes. The patient usually spends the night in the hospital to avoid postoperative pain. Post-procedure rehabilitation will depend on the intervention performed.
a. Shoulder Impingement Syndrome - Compression or impingement syndrome is one of the many pathologies associated with the soft tissues of the shoulder, which affects the tendon of the supraspinatus muscle, generating the well-known supraspinatus tendinitis. Impingement is the mechanical pinching of the soft tissues between the head of the humerus and the subacromial arch.
Structures that can become impinged include both the subacromial bursa and the supraspinatus tendon. For this reason, impingement syndrome is often associated with shoulder bursitis or shoulder tendonitis. When these structures become pinched, inflammation occurs which causes shoulder pain.
b. Frozen Shoulder - Frozen shoulder or adhesive capsulitis is a disease characterized by pain and loss of mobility of the shoulder, usually without any demonstrable alteration in the shoulder itself. Pain is usually the first symptom, leading to reduced shoulder movements. There is usually night pain that makes it difficult to fall asleep. Shoulder movements are reduced whether the patient tries to move it himself or the doctor tries. Frozen shoulder usually appears and progresses slowly, although occasionally it does so quickly.
c. SLAP Tear - SLAP is an abbreviation for anterior to posterior superior labrum. This type of labrum injury occurs most frequently in athletes who throw upward, such as baseball players and tennis players. The SLAP tear is located at the top of the shoulder socket, where the biceps tendon joins the shoulder. This can also occur from a fall onto the outstretched hand or lifting a heavy object.
d. Shoulder Bursitis - Within the shoulder joints, you can find a small ''sachet '' also called bursa, with a small amount of fluid whose function is to serve as a cushion for the tendons, muscles and bones of the joint, thus helping their movement and reduce friction between them. Inflammation of the bursa is known as bursitis, causing pain with it and, therefore, limitation in movement.
e. Shoulder Bone Spurs - A bone growth that appears on normal bone is known as a bone spur or osteophyte. A bone spur is generally smooth, but can cause severe pain if it rubs or presses on other structures such as bones or soft tissues including tendons, nerves, or ligaments in the shoulder.
While initial consultation with a shoulder specialist in New York can cost you around $500-$600, shoulder arthroscopy in New York costs around $7500-$8000 on average.
Medical conditions that can be treated with shoulder arthroscopy in New York are:
