Arthroscopy of the shoulder joint is a modern diagnostic and therapeutic method that allows studying and solving problems with joints. The procedure is minimally invasive - that is, done with a small device inserted into the articular tissue through a microscopic opening. Thanks to this, after arthroscopy on the body there are no visible traces of surgical intervention.
Arthroscopy - indications
A specialist should be sent to the procedure. Shoulder arthroscopy is prescribed by rheumatologists for chronic tendon dystrophy, muscle ruptures, joint instability, acromolecular-clavicular arthrosis. Very often referrals to the procedure are given to athletes when the rotational cuff ruptures. Another indication for arthroscopy is the so-called habitual dislocation.
Diagnostic arthroscopy
It is carried out only when all other available methods of research do not work, and the cause of pathological symptoms remains unsettled. Diagnostic arthroscopy of the shoulder joint allows you to study in detail and "feel" all parts of the joint, assess their condition, identify the existing violations. The diagnostic procedure differs from the treatment procedure in that a camera is inserted into the puncture, making detailed photographs.
Arthroscopy of the shoulder joint is prescribed in such cases:
- Instability of the shoulder joint. In this condition, the ligaments can not keep the head of the humerus in the correct position, and as a result, dislocations with subluxations occur. Diagnosis can determine the damage to the joints, ligaments, capsules.
- Chronic pain. They can appear against the background of pathological changes inside the joint apparatus.
- Damage to the head of the bicep. In most cases, they are injured. Diagnostic arthroscopy of the shoulder joint can not only detect damage, but also determines its origin.
- Impeachment syndrome. It develops due to inflammation and bone growths in the cuff of the shoulder. Characterized by soreness, impaired mobility of the joint.
- Damage to the cartilaginous lip. This pathology is caused by trauma or disease and diagnosed without arthroscopy is very difficult.
- Chondromatosis. The disease leads to coarsening of the synovial membrane of the joint capsule and the appearance of cartilaginous nodules on it.
- Rupture of the rotator cuff. In this case arthroscopy of the shoulder joint can reveal the place of rupture of tendons , of which the cuff is made up.
Therapeutic arthroscopy
This procedure is more complicated. Therapeutic arthroscopy of the shoulder joint testimony has the following:
- Hypermobility. With this diagnosis, the shoulder moves in amplitude, exceeding the capacity of ligaments with cartilages, because of which the latter can be injured.
- Shoulder-scapular periarthritis . The disease develops against the background of excessive physical exertion and is characterized by pain in the hands, numbness.
- Free bodies in the joint cavity. The formations consist of bone and cartilaginous tissues. Arthroscopy treatment of the shoulder joint helps to remove the "extra" fragments without injuring the tissues of the joint apparatus.
- Dysplasia of the articular fossa of the scapula. Because of the pathology, the humerus bones are easier to jump out of the cavity, which increases the risk of injury to the joint.
- Damage to Bankart. With this ailment, the joints and capsules break away from the bone. Arthroscopy is prescribed to superimpose a special suture.
- Frequent stretching. Happens, as a rule, in swimmers. Regular injuries make joints more fragile.
- Habitual dislocation . In most cases, it results from a shoulder injury and improper treatment. The operation consists in moving the long biceps head so that it can stabilize the joint.
- Depressed neck fracture. Such a trauma very often leads to disruption of the movements of the shoulder joint. To restore everything, during the arthroscopy, the surgeon needs to cross the bone and fix all the fragments in a new way.
Arthroscopy - contraindications
All procedures have contraindications, and arthroscopy of the joints, too. It is not recommended to resort to this method of diagnosis and treatment when:
- fibrotic or bone ankylosis;
- presence of infected wounds;
- purulent inflammatory processes in the periarticular tissues;
- general severe condition of the patient.
These contraindications are considered absolute. Under these conditions, the operation is strictly forbidden. There are also relative contraindications. Among them are the conditions under which in some cases a specialist can perform an operation. These include:
- extensive damage (torn ligaments and joint capsules, breach of joint tightness);
- large-scale hemorrhage in the joint.
How is arthroscopy done?
Before the procedure, a complete examination is mandatory. The patient must pass a general analysis of urine, blood, make an ECG, undergo an examination with a narrow specialist. On the day of surgery, you can not eat or drink in the morning, and on the evening before the day you need to put a cleansing enema . A few days before the intervention with the patient, surgeons and anaesthesiologists must communicate.
The manipulation itself is done like this:
- Arthroscopy of the shoulder joint begins with the patient's location on the operating table. As a rule, it is put on a healthy side, and the patient's hand is lifted and pulled using suspended weights.
- Before entering the arthroscope, a certain amount of saline is supplied through the needle through the needle. This is necessary to stretch the cavity.
- At the next stage, an incision is made where the device is inserted.
- When the problem is discovered, the doctor inserts the necessary tools into the joint through additional incisions in the skin, and then sutures them and closes them with a bandage.
Arthroscopy of the shoulder joint - what anesthesia?
In most cases arthroscopy of the shoulder joint anesthesia local suggests. The general is used only in the most difficult cases. The patient makes the final decision together with specialists. The choice is individual, and while one is suitable for mask anesthesia, others have to inject anesthetic into the vertebral canal so that anesthesia is achieved at the level of the spinal cord.
How long does an operation on the shoulder joint - arthroscopy?
Both the operation and recovery after arthroscopy do not take too much time. The procedure, as a rule, lasts no more than 60 minutes. The tissues after healing surgically heal quickly - their damage is minimal - and hospitalization lasts no longer than 4 days. Thanks to this operation, arthroscopy has been recognized by specialists around the world.
Arthroscopy of the shoulder joint - rehabilitation after surgery
This stage of treatment is very important. Rehabilitation after arthroscopy of the shoulder joint represents a set of measures aimed at preserving the functionality and restoring the operability of the joint. Immediately after surgery, the doctor warns of infection by bandaging the seams. Some patients require a cool compress. In addition, rehabilitation after arthroscopy suggests:
- administration of pain medication;
- taking antibiotics;
- wearing a fixative - orthesis - bandages;
- exercise therapy;
- restriction of large physical exertion for half a year after the operation.
LFK after arthroscopy of the shoulder joint
In order to study, do not necessarily go to the gym. Exercises after arthroscopy of the shoulder joint are simple, and they can be performed at home:
- Squeeze your fingers. For convenience, you can use an expander.
- Bend and unbend the brush.
- Move the shoulder girdle: reduce and dilute the shoulder blades, lift and perform rotational movements with the forelegs.
Complications after arthroscopy of the shoulder joint
When properly performed operations with them it is very difficult to encounter, but it is necessary to know about them. Arthroscopy complications can have the following:
- swelling;
- pain in the joint region;
- decreased sensitivity and numbness of the limb;
- bleeding.