Shoulder arthroscopic debridement

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 around 60% of patients having a 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 arthroscopically 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.

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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