What is arthroscopic shoulder instability surgery?

Arthroscopic surgery for shoulder instability repairs a shoulder that is unstable and slips in and out of its socket. This can cause pain. It can also limit how well you can move your shoulder.

To do the surgery, the doctor puts a lighted tube through small cuts (incisions) in your shoulder. The tube is called an arthroscope or scope. Next, the doctor puts some surgical tools in the scope to help make needed repairs. Then the incisions are closed. You will have scars, but they usually fade with time.

Most people go home the same day of the surgery. You will wear a sling for a few weeks.

You may be able to do easy daily activities in 2 to 3 weeks. Just don't use your affected arm. Most people who work at desk jobs can go back to work at this time. But if you lift, push, or pull at work, you will probably need 3 to 4 months off.

Most people can start to do activities that have a low risk of shoulder injury in about 3 months. Jogging is one example. If you play sports, training may also start at this time. Most baseball or softball players can start to toss a ball lightly. But it may take about 6 months to return to normal throwing. How long it takes depends on how damaged your shoulder was. It also depends on how well your rehabilitation (rehab) program goes.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. You may be more comfortable if you sleep in a reclining chair. To make your arm and shoulder feel better, keep a thin pillow under the back of your arm while you are lying down.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• For 2 to 3 weeks, avoid lifting anything heavier than a plate or a glass with your affected arm.
• Wait until your shoulder is completely healed and your doctor says it is okay before you do activities that stress your shoulder. These include chopping wood, playing contact sports like football or sports with risk of falls, lifting heavy weights, and doing overhead work such as painting a ceiling.
• Ask your doctor when you can drive again.
• You may shower after your bandage is removed. Do not take a bath until the incisions are healed. This is about 2 to 3 weeks after surgery. Remove the sling and keep your arm at your side while you shower.
• Most people who work at desk jobs can return to work in 2 to 3 weeks. If you lift, push, or pull at work, you will probably need 3 to 4 months to recover.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids, unless your doctor tells you not to.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have a dressing over your incision, keep it clean and dry. Your doctor will let you know when to remove it.
• If your incision is open to the air, keep the area clean and dry.
• If you have strips of tape on the incision, leave the tape on for a week or until it falls off.

Exercise

• You will need rehabilitation. This is a series of exercises you do after your surgery. Rehab helps you get back your shoulder's range of motion and strength. You will work with your doctor and physical therapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you.

Ice

• Put ice or a cold pack on your shoulder for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin. If your doctor recommended cold therapy using a portable machine, follow the directions that came with the machine.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Arthroscopy is a way to find problems and do surgery inside a joint without making a large cut (incision). Your doctor put a lighted tube with a tiny camera—called an arthroscope, or scope—and surgical tools through small incisions in your shoulder.

You will feel tired for several days. Your shoulder will be swollen. And you may notice that your skin is a different color near the cuts the doctor made (incisions). Your hand and arm may also be swollen. This is normal and will go away in a few days. Depending on the medicine you had during the surgery, your entire arm may feel numb or like you can't move it. This goes away in 12 to 24 hours.

You will have sutures (stitches) and a bandage on your shoulder. You may be able to take off the bandage in about 3 days, or when your doctor tells you. Your arm will also be in a sling for at least 1 week and maybe as long as 6 weeks. You may take the sling off when you dress or wash and during rehabilitation (rehab). If the sutures are not the type that dissolve, your doctor will take them out 7 to 10 days after your surgery.

You will need rehab. This will probably start 1 to 2 weeks after your surgery and last for 4 to 6 months.

You may be able to do easier daily activities in 2 to 3 weeks. Most people who work at desk jobs can go back to work at this time. If you lift, push, or pull at work, you will probably need 3 to 4 months off.

Most people can start activities with low risk of shoulder injury in about 3 months. This includes jogging and lifting light weights. If you play sports, then training may also start at this time. Most baseball or softball players can start a program to toss a ball lightly. It may take about 6 months to return to normal throwing. How long it takes depends on how damaged your shoulder was and how well your rehab goes.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You may be asleep or have medicine to relax you. And if you're awake, the area will be numbed. It's often numbed even if you are asleep.
• The surgery will take about 2 to 3 hours.