The shoulder is made up of three joints. The joints are known as the acromioclavicular, sternoclavicular and glenohumeral joints. The glenohumeral joint is the main joint and is what most people think of as the shoulder joint. It is made up of:

• Bones
• Muscles
• Tendons
• Ligaments
• Cartilage

The glenohumeral joint is a ball-and-socket joint.

• The ball of the glenohumeral joint is the top of the upper arm bone (humerus). The socket is the part of the shoulder blade (scapula) known as the glenoid.
• The humerus is held in place by four muscles and tendons. This group of muscles and tendons is known as the rotator cuff.
• On the outside edge of the socket there is a rim of cartilage called the labrum. The labrum helps make the socket deeper and keep the humerus in place.

The structure and functions of the shoulder joints make it prone to injury, degeneration and pain. Shoulder pain is a very common complaint. It may be caused by problems with either the glenohumeral or acromioclavicular joints. These problems are most often caused by:

• Overuse
• Injury
• Degenerative changes
• Inflammation
• Infection

A shoulder arthroscopy is a surgical procedure that uses small medical instruments and a camera to look inside the shoulder joint. The instruments are inserted into the shoulder joint through small incisions made in different areas of the shoulder. A shoulder arthroscopy with rotator cuff repair is done to diagnose and repair a torn tendon. Not all rotator cuff tendon tears require surgery. The decision whether to have surgery depends on many factors including the:

• Type and size of the tear
• Degree of pain
• Response to non-operative treatment
• Age, activity level, degree of instability and condition of the other structures in the shoulder joint

There are times when the surgeon cannot repair the tendon through the arthroscope. In those cases, the repair will need to be done through a larger incision in the upper shoulder.

A tear in one of the tendons of the rotator cuff can cause:

• Shoulder pain
• Instability and weakness
• Problems using the shoulder joint properly

Not all rotator cuff tendon tears cause significant shoulder complaints and may not require surgery. Many of these injuries improve significantly or even resolve over time. Conservative treatments you can try at home to relieve shoulder pain include:

• Resting the affected arm and shoulder for a day or two.
• Applying ice to the shoulder to reduce inflammation and pain. Do not use ice longer than 15 minutes at a time. Do not apply ice directly to your skin.
• Physical therapy may be recommended to help strengthen your shoulder and prevent future injury. This will include exercises you can do at home.

Your healthcare provider may also recommend over-the-counter pain medications. These can include:

• Nonsteroidal/anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
• Mild pain relievers that do not have anti-inflammatory effects, such as acetaminophen

Sometimes, these medications can cause side effects and interfere with other medications you are taking. Ask your healthcare provider which one is right for you.

If your symptoms persist, your healthcare provider may recommend imaging studies (x-rays or an MRI). A shoulder arthroscopy and repair of a torn tendon may be recommended if someone has:

• A complete/large tear of the tendon
• Extreme weakness in the affected arm
• No improvement with physical therapy, exercises and medication (conservative treatments)
• Symptoms that severely affect the quality of life of athletes, active people or workers who need to use their shoulders extensively

Prior to surgery, tell your healthcare provider about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before surgery. These may include:

• Medications you should not take before the surgery, such as blood thinners
• Regular medications you should take on the day of your surgery
• How many hours you should stop eating and drinking before surgery

If you are a smoker, you should quit smoking, as it can interfere with your recovery.

During your arthroscopy, you will receive anesthesia to keep you comfortable and pain free.

• General anesthesia, the most common type of anesthesia for a shoulder arthroscopy, is where you are put into a deep sleep and are unable to see, hear, or feel anything.
• Other types of anesthesia may also be used for this surgery.
• You will probably go home the day of your surgery. Your arm will be in a sling for a few weeks. You may be allowed to move your arm once in a while. This will help prevent stiffness and weakness.
• Physical therapy is often recommended for several weeks after surgery to improve your shoulder strength and mobility.
• You may also need pain medication and help at home while you recover.

What should I ask my healthcare provider before having a shoulder arthroscopy and rotator cuff repair?

What should I ask my healthcare provider before having a shoulder arthroscopy and labral lesion repair?

• What is my diagnosis and reason for the surgery?
• Do I need any tests before surgery? What are the benefits and risks of having the tests? Will the tests change your treatment recommendations? If not, is there a need for the test?
• Is non-surgical treatment an option? If so, what kind?
• What are the pros and cons of surgery?
• What if I prefer non-surgical treatment? How long should I try non-surgical treatment before revisiting the option of surgery?
• How will I feel after the surgery? Will I have to modify my activity?
• How long is the period of rehabilitation likely to be?
• What is your experience in doing this type of surgery? What is your complication rate?
• Is there any special preparation for the surgery? (If so, get clear instructions on what you need to do.)
• If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

Do not forget to arrange for transportation to and from the facility and for help at home.

Before you go home, make sure you understand all home care instructions (including medications and side effects), what symptoms you should report to your healthcare provider after discharge and follow-up plans. Your surgeon should also communicate with your primary care physician.

Source UHC.com

Also known as:

Torn Rotator Cuff

Tendon Tear

Shoulder Strain

Shoulder Pain

Shoulder Injury

Shoulder Arthroscopy

Rotator Cuff Tear

Painful Shoulder

Hurt Shoulder

Arthroscopy Shoulder