Arthroscopy is a procedure that orthopedic surgeons use to inspect, diagnose, and treat problems inside a joint.
The word arthroscopy comes from two Greek words, "arthro" (joint) and "skopein" (to look). The term literally means "to look within the joint." During shoulder arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your shoulder joint. The camera displays pictures on a video monitor, and your surgeon uses these images to guide miniature surgical instruments.
Because the arthroscope and surgical instruments are thin, your surgeon can use very small incisions (cuts), rather than the larger incisions needed for standard, open surgery. This results in less pain for patients and shortens the time it takes to recover and return to favorite activities.
Shoulder arthroscopy has been performed since the 1970s. It has made diagnosis, treatment, and recovery from surgery easier and faster than was once thought possible. Improvements to shoulder arthroscopy occur every year as new instruments and techniques are developed.
Anatomy
The shoulder is a complex joint that is capable of more motion than any other joint in the human body. It is made up of three bones:
The humerus (upper arm bone)
The scapula (shoulder blade)
The clavicle (collarbone)
This illustration of the shoulder highlights the major components of the joint.
Ball-and-socket. The head of the upper arm bone fits into a rounded socket in the shoulder blade. This socket is called the glenoid. A slippery tissue called articular cartilage covers the surface of the ball and the socket. It creates a smooth, frictionless surface that helps the bones glide easily across each other.
The glenoid is ringed by strong fibrous cartilage called the labrum. The labrum forms a gasket around the socket, adds stability, and cushions the joint.
Shoulder capsule. The joint is surrounded by bands of tissue called ligaments. They form a capsule that holds the joint together. The undersurface of the capsule is lined by a thin membrane called the synovium. It produces synovial fluid that lubricates the shoulder joint.
Rotator cuff. Four tendons surround the shoulder capsule and help keep the arm bone centered in the shoulder socket. This thick tendon material is called the rotator cuff. The cuff covers the head of the humerus and attaches it to the shoulder blade.
Bursa. There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa helps the rotator cuff tendons glide smoothly when you move your arm.
When Shoulder Arthroscopy Is Recommended
Your doctor may recommend shoulder arthroscopy if you have a painful condition that does not respond to nonsurgical treatment. Nonsurgical treatment includes:
Rest
Physical therapy
Medications or injections that can reduce inflammation and allow injured tissues to heal (inflammation is one of your body's normal reactions to injury or disease; in an injured or diseased shoulder joint, inflammation causes swelling, pain, and stiffness)
Injury, overuse, and age-related wear and tear are responsible for most shoulder problems. Shoulder arthroscopy may relieve painful symptoms of many problems that damage the rotator cuff tendons, labrum, articular cartilage, and other soft tissues surrounding the joint.
