Arthroscopy Shoulder Surgery

Arthroscopic shoulder surgery usually involves an anaesthetic, which is usual in the form of general anaesthesia. The patients are positioned in a lateral position and the arthroscope is inserted into the shoulder joint. An inspection of the glenohumeral joint is first undertaken and any particular pathology may be addressed at this stage. When performing arthroscopic stabilisations (or arthroscopic shoulder labral repair) the labral tissue is first inspected and the arthroscope is then inserted into the anterior portal and the back of the joint is assessed. In some situations the labrum is either detached or partially healed in an alternate position and this must be released. The extent of bony damage to both the glenoid and the humerus is undertaken and assuming there isn’t significant bony damage, an arthroscopic approach is continued. The labrum is released and brought to its new position, the glenoid rim is resurfaced and the labrum repaired with anchors. I tend to use 2.3mm PEEK anchors in different positions.

For rotator cuff pathology the arthroscope is entered into the acromial space and this is assessed. If there is impingement syndrome most shoulder arthroscopic surgeons in Melbourne will perform this purely keyhole. The impinging surfaces are removed which usually includes the acromion and the bursa. The AC joint can provide a secondary side of impingement. The C.A. ligament is often a sign of impingement and can be removed. The rotator cuff is then reassessed and may be repaired if required.