What is a Shoulder Arthroscopic Debridement?
Shoulder Arthroscopic Debridement operation is to relieve pain
and restore movement to the shoulder. The operation is suitable for
people who have rotator cuff tears that cannot be formally
repaired. The operation always needs to be accompanied by a
specialist course of physiotherapy to get the other muscles around
the shoulder working as well as possible.
Overall this sort of surgery should have a success rate of one
out of two with substantial reduction in pain and a return to
normal activity.
What does this involve?
Shoulder Arthroscopic Debridement is performed under general
anaesthetic and takes around one hour. Local anaesthetic is
also used as part of the pain relieving technique either by direct
injection into the site of the surgery or by numbing the nerves to
the whole arm using a technique called a regional block. This is
similar to the idea of an epidural anaesthetic frequently used in
childbirth and can have benefits in not only providing excellent
postoperative pain relief but also in reducing postoperative
sickness and nausea.
The operation is carried out telescopically through small incisions
around your shoulder. The first step in the operation is to carry
out a thorough examination and assessment of your shoulder,
including the damaged tendons and any arthritis in the joint. A
variety of different procedures may then be carried out to achieve
the goals of the surgery. If movement of the shoulder is
restricted, releases of the tight ligaments are carried out. In
some people, part of the biceps tendon is getting caught or trapped
as the arm is lifted up and that part of the tendon needs to be
released. A small amount of bone may need to be removed but this
should always be done much more cautiously than in people whose
tendons are intact or can be repaired.
Once the operation is complete, the small incisions are closed
with single stitches that are removed after a week and covered with
waterproof dressings.
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When will I recover?
The operation generally requires a one night stay in hospital
and your arm is placed into a special shoulder sling which is
primarily for comfort and support. Exercises and physiotherapy
start on the day of surgery and patients are your physiotherapist
will teach you all you need to know for the first couple of weeks
after discharge from hospital.
As a general guideline the sling is rarely necessary for a
period of more than two weeks. During this time, you are encouraged
to start using your hand but it is unlikely that you will be able
to do much actively with the arm when the shoulder is moved away
from the body. Most people can start driving a car between two and
three weeks and have regained good ordinary use of the shoulder by
six weeks. By this stage it is usually apparent whether the
surgery has been worthwhile and there are no particular
restrictions on level of activity.
In addition to regular treatment with the physiotherapist,
follow up should be carried out by your surgeon. This is to monitor
and guide progress and look out for complications, which are
fortunately rare.
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What risks should I know about?
Shoulder Arthroscopic Debridement is a very
successful operation but there are some potential complications you
should be aware of even though they are uncommon.
- Infection can occur although it is rare and infection rates are
less than 1%.
- Shoulder stiffness can occasionally be triggered off by the
operation and can be treated by injection.
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