Arthroscopic and Reconstructive Shoulder Surgery
Arthroscopic and Reconstructive Shoulder Surgery
Arthroscopic and Reconstructive Shoulder SurgeryArthroscopy is a surgery Dr. Ignacio performs, to inspect, diagnose, and treat problems inside the shoulder joint.
What is Arthroscopic and Reconstructive Shoulder Surgery?
Arthroscopy literally means “to look within the joint.” During arthroscopy, Dr. Ignacio inserts a small camera into your shoulder joint.
The camera displays pictures on a video monitor, and she uses these images to guide miniature, specialized surgical instruments.
Because the arthroscope and surgical instruments are thin, Dr. Ignacio can use very small incisions (cuts), rather than the larger incisions needed for standard, open surgery.
This results in less pain and stiffness for patients and shortens the time for rapid recovery and return to getting back in the game, back to work, and their favorite activities.
Dr. Elizabeth Ignacio, MD
Dr. Ignacio is fellowship-trained and board-certified by the American Board of Orthopedic Surgery as an expert in minimally invasive advanced arthroscopic and reconstructive orthopedic surgery and sports medicine, to return you back to activity as safely and quickly as possible.
She has been in practice for two decades, and has trained other surgeons, both on the continental US and here in Hawai‘i, and she is honored to be chosen as a Master Instructor at the prestigious international Masters Course in arthroscopy, for the American Academy of Orthopedic Surgeons and the Arthroscopy Association of North America.
Who is it for?
With certain specific types of injuries, or when other conservative treatment options have been utilized without success, surgery may be the best option for long-term, definitive positive results. Dr. Ignacio may recommend shoulder arthroscopy due to the type of injury, your desired activity level, or if you have a painful condition that does not respond to nonsurgical treatment. Nonsurgical treatment includes rest, physical therapy, and medications or injections that can reduce inflammation. Shoulder arthroscopy may relieve painful symptoms of many problems that damage the cartilage surfaces and other soft tissues surrounding the joint.
Common arthroscopic procedures for the shoulder include:
- Rotator Cuff Repair
- Shoulder instability repair
- Labral Repair
- Biceps tendon repair/tenodesis
- AC joint reconstruction for separation dislocation
- Bone spur arthroscopic removal and decompression
- Joint Manipulation under anesthesia and lysis of adhesions
What to Expect After Arthroscopic Shoulder Surgery?
After surgery, you will be moved to the recovery room and should be able to go home within 1 or 2 hours.
Because of the anesthesia, you must have someone with you to drive you home. While arthroscopy is minimally invasive and recovery is predictably faster than recovery from traditional open shoulder surgery, it is important to follow instructions carefully after you return home.
That is why you are given a handout of the postoperative expectations and instructions one week prior to your surgery, at the pre-op visit with Dr. Ignacio, so you have time to review the instructions.
After surgery, you will feel some pain, and this is a natural part of the healing process. Medications are prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, like anti-inflammatories to help with the swelling, opioid pain medications, and local anesthetics. Fortunately, it’s been Dr. Ignacio’s consistent experience that her patients have only needed the pain medication for just a few days at most.
Opioids are a narcotic and can be addictive. Opioid dependency and overdose has become a critical public health issue in the U.S. It is important to use opioids only as directed and to stop taking them as your pain begins to improve.
In addition to medicines for pain relief and swelling (which is a source of pain and stiffness), Dr. Ignacio may prescribe anti-nausea medication for patients sensitive to anesthesia and pain medications. She also may recommend medication such as aspirin to lessen the risk of blood clots.
You will leave the surgical facility with a dressing covering your knee. Keep your incisions clean and dry for 48 hours. No soaking/immersion, such as in a bath, pool, hot tub, or ocean, for 2 full weeks.
Because arthroscopy, by definition, is surgery on a joint, mitigating swelling and stiffness, as well as recovery of strength and flexibility is optimal for full recovery.
Dr. Ignacio is a proponent of physical therapy after arthroscopic surgery, again reiterating that half of the success comes from the surgery, but the remaining half of the overall success is based on compliance with the rehab rules and protocol afterwards.
Working with a physical therapist is the best way to return to activities quickly but safely. If a repair or reconstruction is performed, physical therapy will focus first on regaining and optimizing mobility with passive range of motion exercises, because the basis of one’s overall function of the shoulder is based on mobility.
The passive exercises allow for protecting the repair/reconstruction while it heals Once full motion is obtained, the second phase of rehab will then focus on strengthening exercises and active range of motion.
How successful is arthroscopic shoulder surgery?
Many people return to full, unrestricted activities after arthroscopy. Your recovery will depend on the type of damage that was present in your shoulder, as well as your postoperative commitment and compliance to the rehab protocol. Half of the success is due to the surgery, but the remaining half of the overall success and functional recovery is the rehab afterwards.
Unless you have had a repair or reconstruction, or cartilage restoration surgery, you should be able to return to most physical activities after 6 to 8 weeks, or sometimes much, much sooner.
The overall goal always is to get you back to any and all activities you’d like to do, as quickly yet safely as possible, with a continued focus on peak performance and injury prevention longterm.