Shoulder Arthroscopy Specialist Treating Patients in Houston, Beaumont and Cypress
Arthroscopy is a minimally invasive diagnostic and surgical procedure performed for joint problems. Shoulder arthroscopy is performed using a pencil-sized instrument called an Arthroscope. The arthroscope consists of a light system and camera to project images to a computer screen for your surgeon to view the surgical site. Arthroscopy is used to treat disease conditions and injuries involving the bones, cartilage, tendons, ligaments, and muscles of the shoulder joint.
The shoulder joint is made up of a ball and socket joint, where the head of the humerus (upper arm bone) articulates with the socket of the scapula (shoulder blade) called the glenoid. The two articulating surfaces of the bones are covered with cartilage, which prevents friction between the moving bones enabling smooth movement. Tendons and ligaments around the shoulder joint provide strength and stability to the joint. Injury and disease to the bones or soft tissues of the shoulder joint can make it instable, and lead to pain, inflammation and reduced mobility.
Shoulder arthroscopy is indicated to treat the following shoulder conditions when conservative treatment such as medication and therapy fails to relieve pain and disability:
- Shoulder Impingement: this occurs when the shoulder blade applies pressure on the underlying soft tissues when the arm is lifted
- Rotator cuff tear
- Frozen shoulder or stiffness of the shoulder joint
- Shoulder Instability this occurs when the head of the upper arm bone slips out of the socket of the shoulder blade’s glenoid cavity either due to injury or overuse
- Biceps rupture occurs when the tendons attaching the bicep muscle to the shoulder or elbow tears
- Damaged cartilage or ligaments
- Bone spurs or bony projections
- Arthritis of the collarbone
Your surgeon performs shoulder arthroscopy under general or regional anesthesia. You may be positioned lying down on your side with your arm propped up or sitting in a semi-seated position. Sterile fluid is injected into the shoulder joint to expand the surgical area so your surgeon has a clear view of the damage and room to work. A button-sized hole is made in the shoulder and the arthroscope is inserted. Your surgeon can view images captured by the camera in the arthroscope on a large monitor. Surgical instruments are introduced into the joint through separate small holes to remove and repair the damage to the joint. After surgery, the instruments are removed and the incisions are closed with stitches or small sterile bandage strips.
After the surgery, the small surgical wounds take a few days to heal and the surgical dressing is replaced by simple Band-Aids. The recovery time depends on the type and extent of problem for which the procedure was performed. Pain medications are prescribed to keep you comfortable. The arm of the affected shoulder is placed in a sling for a short period as recommended by your doctor. Physical therapy is advised to improve shoulder mobility and strength after the surgery.
The advantages of arthroscopy compared to open surgery with a large incision include
- Less pain
- Fewer complications
- Shorter hospital stay
- Faster recovery
Risks and complications
Complications of shoulder arthroscopy include infection, bleeding, damage to nearby nerves or blood vessels, or delayed healing after the surgery. In certain cases, stiffness of the shoulder joint may occur after the surgery. It is important to participate actively in your physical therapy to prevent this from occurring.
If you have severe, chronic pain in your shoulder, an orthopedic surgeon can help. Dr. Mufaddal Gombera specializes in minimally invasive procedures that let you recover easily. He can conduct an arthroscopy on your shoulder that involves only a few small incisions. You don't always have to have open surgery to relieve your shoulder problems. Dr. Gombera understands this and prioritizes using the least invasive methods possible.
What Is Shoulder Arthroscopy?
Thanks to modern technology, Dr. Gombera can offer minimally invasive care like arthroscopy. During a shoulder arthroscopy, he uses a small instrument called an arthroscope. This tool has a light and camera that shows him images of the affected joint. He only needs to make a few small incisions and insert the arthroscope to look at the problem. Once he finds the issue, he uses very thin instruments that also fit through the small incisions to treat it. Arthroscopy lets orthopedic specialists treat many conditions without a full operation.
The small incision made during an arthroscopy has many benefits over the large incisions made in open surgery, such as:
- Less pain during recovery
- Fewer complications
- A short or nonexistent hospital stay
- Full recovery within months
When Does a Patient Need Arthroscopic Shoulder Surgery?
Your shoulder joint includes the head of your upper arm bone and the socket in your shoulder blade. These two bones connect to form the joint and have cushioning from the surrounding cartilage. Cartilage covers your arm bone and socket to let the bones glide freely when you move your arm.
The shoulder joint also has ligaments and tendons that stabilize and support the rest of the joint. When injury or disease damage parts of your shoulder joint, they don't work together as they should. As a result, you can experience pain, inflammation and problems moving your shoulder.
Dr. Gombera always tries non-surgical treatment like physical therapy and medicine first when addressing shoulder problems. However, some issues need surgery no matter how many conservative treatment methods are used. In this situation, you don't always have to get open surgery. Arthroscopy has a lower impact on your body than open surgery and treats conditions such as:
- Shoulder impingement, a condition where the shoulder blade presses on the rotator cuff
- A tear in the rotator cuff
- "Frozen shoulder," or stiffness in the shoulder joint
- Shoulder instability, a condition that makes your shoulder dislocate easily
- A rupture in the bicep muscles attached to the shoulder
- Damaged cartilage or ligaments
- Bone spurs, or excess bone that changes the bone shape
How Does Dr. Gombera Use Arthroscopy to Treat Shoulder Issues?
When Dr. Gombera performs a shoulder arthroscopy, he'll give you general or regional anesthesia. General anesthesia makes you fall asleep during the procedure. Regional anesthesia numbs the area where he operates while you stay awake. He'll talk to you about your anesthesia options during a prior appointment. Once you can't feel the surgical area, Dr. Gombera will inject sterile fluid into your shoulder joint. This fluid expands the joint and gives him more room to see and work.
Dr. Gombera makes the first small cut in the shoulder to insert the arthroscope. After he sees the problem in your joint, he'll make additional cuts where he can fit small instruments. Depending on the shoulder issues you have, he may use the instruments to complete one or more of the following procedures:
- Rotator cuff repair: If you have a damaged rotator cuff, Dr. Gombera will put it back together. He'll bring the tendon's edges back together. Then, he'll use small metal or plastic rivets to keep the tendon attached to your bone. These rivets stay in your shoulder after surgery, so you won't have to have another surgery for removal.
- Shoulder impingement therapy: Shoulder impingement inflames the tissue in your shoulder. This inflammation makes the symptoms more severe. Dr. Gombera will clean out any damaged tissue from your shoulder joint to help it heal properly. If you have impingement because of a growth on your acromion bone, he may shave it down so that it stops rubbing against your muscles.
- Shoulder instability treatment: You can have shoulder instability for multiple reasons. Dr. Gombera will address the cause behind your individual case. He'll repair the labrum, or the cartilage on the inside of your shoulder socket, if it has a tear. Any other cartilage and ligaments that have tearing and damage will also get mended.
Once Dr. Gombera completes cleaning and repairs, he'll take out the arthroscope and tools. Then, he'll use small bandage strips with a strong adhesive that keeps your incisions closed. The surgery takes between 30 minutes and three hours to complete. In most cases, you can go home the same day you get the procedure done. Your experience with the surgery will depend on your diagnosis and the work done by Dr. Gombera.
What Should I Expect During Recovery From My Arthroscopy Procedure?
During the time between your arthroscopy and follow-up appointment, you need to take good care of your incisions and avoid putting weight on your shoulder. Within the first week or two after surgery, you'll start a physical therapy plan to strengthen your muscles. Keeping up with this plan will help you get strength and motion back in your shoulder. Dr. Gombera has specialized physical therapy plans for each kind of procedure:
- Removal of damaged tissue and/or shaving of the acromion
- Rotator cuff repair
- Bankart repair/stabilization of your anterior muscle
- Biceps repair
Will I Have a Good Prognosis After Arthroscopic Shoulder Surgery?
Arthroscopy usually involves less pain, faster recovery and fewer complications than open surgery. However, your body needs time to repair itself after the procedure. If you had a treatment for shoulder instability, you might still have some instability after the arthroscopy. Your damaged rotator cuff or tendon won't hurt anymore, but it may not be as strong. Remember to follow Dr. Gombera's directions for self-care after surgery to ensure the best results possible.
How Do I Schedule an Appointment With Dr. Gombera?
Dr. Gombera sees athletes and non-athletes alike for their shoulder, hip and knee problems. No matter what you do in life for fulfillment, he'll find a solution for your pain that will get you back to doing what you love. Schedule an appointment today using our online booking tool, or call us at (713) 794-3457.
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