Articles

ARTHROSCOPIC SURGERY TO CORRECT SHOULDER INSTABILITY

Drigan D. Wieder, M.D.

There are now arthroscopic procedures to correct shoulder instability that are much less invasive than the traditional open surgical procedures.  These arthroscopic procedures are performed on an outpatient basis.  The recovery is greatly simplified and the outcomes are predictably good. 

The shoulder is a unique joint.  It allows a greater range of motion than any other joint in the human body.  The extreme motion is achieved through an intricate balance between the bony architecture and the soft tissue around the shoulder. 

Stability of the shoulder joint is heavily dependent on the soft tissue surrounding the joint, including the muscles of the rotator cuff, the ligaments in the front and back of the shoulder, and the cartilage ring "the labrum" which is attached to the perimeter of the glenoid or socket side of the joint. 

Injuries to these soft tissues can cause laxity or looseness of the shoulder and result in pain, subluxation, or dislocation (instability) of the shoulder. 

Traditionally, shoulder instability is treated with open surgical procedures that require a large incision and extensive dissection of soft tissues to correct the soft tissue injury. 

With the advent to arthroscopy, procedures have been developed which correct many of these problems arthroscopically.  The arthroscopic procedures have several advantages including:

• The procedure is performed on an outpatient basis in a surgery center.
• It is performed through three ¼" long incisions.
• Recovery is more rapid and less painful.
• The results are predictably good.

The procedure is performed in a surgery center or hospital operating room under a general anesthetic.  It takes approximately an hour and a half.  The patient recovers at home.  The patients are seen in the surgeon's office the day following the surgery to begin the recovery phase.  Typically the patient can return to simple activities like typing and writing within 3-4 days.  Physical therapy starts 4 weeks postop and patients gradually return to unrestricted and full activities.

The results are predictably good with elimination of instability, pain, and full return of motion and function.