Shoulder arthroscopy is a medical procedure that allows physicians to look inside the joints of the shoulders to determine the extent of damage to the shoulder or detect any problems that may be occurring in the shoulder. The procedure is typically used when an issue either cannot be diagnosed using less invasive measures or the exact cause of the problem is unknown. Shoulder arthroscopy is usually used in conjunction with x-rays, MRI imaging, and CT scans.
The use of shoulder arthroscopy to diagnose and treat conditions has increased in recent years, mainly due to the success of treating professional athletes with this method and the greatly reduce recovery time for most patients that surgical procedures done using the method. There are relatively few complications associated with the procedure and these complications only affect a small percentage of the individuals who have undergone shoulder arthroscopy. Common complications that may occur include infection, excessive bleeding, blood clots, nerve damage, and, in rare cases, postarthroscopic glenohumeral chondrolysis.
Shoulder arthroscopy is performed by an orthopedic surgeon, typically on an outpatient basis. First, the patient must be anesthetized to minimize the amount of discomfort that the patient will experience while the procedure is being completed. During the procedure, a tiny incision is placed in skin of the shoulder area of the patient. A small camera and lighting instrument are inserted into the incision and the images obtained appear on a television screen in the examination room. The camera and lighting instruments can be moved around the joint of the shoulder to look for any signs of damage, inflammation, or other problems that may be occurring within the joint. Shoulder arthroscopy allows the surgeon to see exactly what has occurred within the shoulder joint and this information will help the surgeon determine the best course of treatment to correct the problem.
There are a large number of issues that can occur which would make shoulder arthroscopy medically necessary. Inflammation is a common cause of an individual having to undergo the procedure as in many cases the cause of the inflammation cannot be found. Injury to the shoulder joint is another reason why a shoulder arthroscopy may be necessary, as the internal method may be needed to determine the extent of the injury. These injuries may include dislocation, torn tendons, damaged cartilage, and over extension of the joint. Shoulder arthroscopy may also be used to determine the exact cause of the injury if unknown at the time of examination.
In certain situations, surgical repairs may be made during the shoulder arthroscopy. This is completed by the use of specially designed instruments that are also inserted into the shoulder incision during the procedure. This allows the surgeon to see where the instruments are positioned and make minute corrections to the shoulder joints without having to make a larger surgical incision that could take longer to heal. The amount of time needed for the procedure and subsequent recovery depends on the extent of the injury and the difficulty of correcting the issue.
Recent studies have linked the use of post-operative, intra-articular high volume shoulder pain pumps following shoulder surgery to a rare, life-altering condition known as Postarthroscopic Glenohumeral Chondrolysis (PAGCL).
Which Shoulder Pain Pumps are Affected?
The devices involved include those manufactured by Stryker Co., DJO Inc., I-Flow Co., BREG Inc. and several others. Most commonly used are:
- Stryker® PainPump 1®
- Stryker® PainPump 2®
- PainPump® Blockaid®
- On-Q® Painbuster®
- Donjoy® Pain Control Device
- Accufuser® Plus Pain Pump