Shoulder Arthroscopy

With the growing awareness of being fit, more and more people are getting involved in heavy exercise and recreational sports leading to various shoulder injuries. A relatively simple and safe procedure, called shoulder arthroscopy, is performed to diagnose and treat many shoulder injuries and diseases. Shoulder Arthroscopy is done using a small camera, called an arthroscope, which helps in examining and performing surgery on the bones and soft tissues in and around the shoulder. Most surgeons prefer arthroscopy instead of open shoulder surgery because there is less chance of infection and the shoulder heals more quickly.

Anatomy of the Shoulder

The shoulder is a ball-and-socket joint where the arm joins the upper part of the body. The ends of the two bones, the humerus (upper arm bone) and the scapula (shoulder blade) are covered by articular cartilage. The smooth surface of the articular cartilage makes movement of the joint easy and pain free. The shoulder joint (acromioclavicular joint) is held together by a group of muscles and tendons called the rotator cuff. A healthy rotator cuff keeps the ball of the humerus in the socket (glenoid) of the scapula and aids in the movement of the shoulder in many directions. Injury or disease of the rotator cuff from overuse, injury or trauma can cause pain and instability in the shoulder.

See Anatomy of the Shoulder for more details.

Shoulder Problems Diagnosed or Treated With Arthroscopy

Shoulder arthroscopy may be done to diagnose or treat the following:

Rotator Cuff Tear or Injury

Rotator cuff repair: The edges of the muscles are brought together. The tendon is attached to the bone with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic. They do not need to be removed after surgery.

Shoulder Instability

Instability is when bony segments cannot maintain alignment due to torn or lax ligaments and weak muscles. Shoulder Instability is when the shoulder joint becomes loose and the joint dislocates—the ball slips out of the socket.

Surgery for shoulder instability: If you have a torn labrum, the rim of the shoulder joint that is made out of cartilage, your surgeon can repair it.

Labral or Ligament Tears

Shoulder arthroscopy is a commonly used for tears of a labrum, like a Bankart lesion or SLAP lesion, as well as ligament tears. Rehab after the arthroscopy for these problems play an important role in getting back to normal.


The labrum of the shoulder is the soft tissue “washer” of the shoulder socket. This tissue can be caught between the socket and the
humerus and be torn. This flap of tissue can move in and out of the joint, getting caught between the humeral head and glenoid socket, and cause pain and catching.


The main symptom caused by a labral tear is usually a sharp catching type sensation in the shoulder. This may be followed by a vague aching
for several hours. This “catching feeling” may occur only with certain movements of the shoulder.


The diagnosis of a labral tear may be suggested by the history and the physical examination. The tear is sometimes visible on the MRI Scan, or
in a CT Scan with special dye in the shoulder. The diagnosis of a labral tear may rely on looking into the shoulder with the arthroscope.


The arthroscope can also be used to remove the tear and determine what other injuries may have occurred in the shoulder.

Shoulder Impingement Syndrome

Impingement syndrome is a condition where the rotator cuff tendons become inflamed at the subacromial space causing pain, weakness and loss of movement of the shoulder. Arthroscopic subacromial decompression (cleaning out the space under the acromion) removes the bursa (the fluid-filled sac near the shoulder joint) and other bony projections (bone spurs) that may be causing the irritation creating space for the tendons and helping reduce inflammation. Decompression is done when other conservative treatments don’t work.

Surgery for impingement syndrome: Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. Your surgeon may also cut a specific ligament, called the coracoacromial ligament, and shave off the under part of a the acromion.

Frozen Shoulder

A frozen shoulder, called adhesive capsulitis, is a condition where the connective tissues surrounding the shoulder joint become inflamed causing pain and restricting the movement of the shoulder. Similar to impingement syndrome, arthroscopy for frozen shoulder is done only after conservative therapy doesn’t work. An arthroscopic procedure for a frozen shoulder should be immediately followed by physical therapy to reduce chances of the problem coming back.


Arthritis or inflammation of the joint, an arthroscopic procedure is performed to remove the damaged bone to regain normal movement of the shoulder joint. Shoulder arthroscopy may also be done to relieve the arm from problems related to arthritis like cartilage inflammation or tear, ligament rupture, or even when the joint surfaces become rough due to constant rubbing against each other.

Torn or Damaged Biceps Tendon

The biceps tendon becomes inflamed from impingement syndrome or rotator cuff tears. It can also become inflamed on its own. In order to relieve the symptoms of biceps tendonitis, an arthroscopic procedure called the biceps tenodesis is performed to anchor the tendons and prevent further problems.

Preparing for Shoulder Arthroscopy

Be sure to tell your surgeon about all prescription and non-prescription medicines you are taking, including alcohol, supplements, cigarettes, or herbs. Include the name, the amount and how often you take them. Ask your surgeon which medications you should take on the day of your surgery.

Two Weeks Before Surgery

To prepare shoulder arthroscopy you may need to get an urinalysis and blood tests. If you are over 50, you may also need an EKG, chest x-rays to make sure you’re OK for anesthesia. If you have other illnesses like diabetes, heart or lung disease, you will need clearance for the surgery from your regular doctor. If you take medications that cause thinning of the blood—like ibuprofen, aspirin, naproxen—you should stop taking these medicines about two weeks before your surgery.

If you are suffering from an illness like a cold, flu, fever, herpes or infection within a week of your surgery, tell your surgeon—your surgery many need to be postponed to prevent complications.

If you smoke or use tobacco products, stop them before surgery. Nicotine slows down the healing process for tissues and bone. Ask your ways to help you stop. Do not use nicotine patches to help you stop since you will still be getting nicotine. If you drink more than one or 2 drinks a day, be sure to tell your surgeon.

The Day of Surgery

Don’t eat or drink anything after midnight of the day of your surgery. Take the daily medicines with just a sip of water that your surgeon said it’s OK to take. Arrive at the hospital or surgical center on time.

You will probably go home the day of surgery, so wear clothes that are easy to get on and off. Your shoulder will be in a sling so zippers and ties will be all but impossible with one hand. Buttons are OK, snaps are better. You can’t raise your arm to put on a sweatshirt or T-shirt. A big shirt or jacket that buttons or snaps up the front will work well. Wear pants that you can slip on and have an elastic waistband, like sweat pants or exercise shorts. Wear shoes, without stockings or socks, that slip on like flip flops, clogs, loafers, or sandals.

Anesthesia for Shoulder Arthroscopy

Usually a combination of both regional anesthesia and general anesthesia is used. The regional anesthesia makes the arm and shoulder numb so you don’t feel any pain during surgery. General anesthesia puts you to sleep and is used to make you comfortable during surgery.

Shoulder Arthroscopy

Shoulder arthroscopy begins with a few small incisions made at the shoulder area. The arthroscope, which is connected with a video monitor, is inserted through one of these incisions. The other incisions are for inserting equipment needed for the repair, reconstruction, etc. The arthroscope helps the surgeon to get a clear view of the shoulder joint and adjoining cartilage, ligaments and tendons to diagnose the exact problem.

At the end of the procedure, all the incisions are taped, the area is bandaged you’ll be taken to the recovery room.

Risks and Complications of Shoulder Arthroscopy

Shoulder arthroscopy is a safe procedure and the chances of complications are low. However, it’s important to know the risks and complications so that it’s easier to identify if it actually happens.

Risks include:

• Bleeding, infection, or blood clots.
• Infection, vomiting, nausea, urinary retention, sore throat, headache from the anesthesia. Some serious effects of anesthesia include strokes, heart attacks and pneumonia.
• Shoulder stiffness or weakness and/or loss of some or all sensation.
• The repair doesn’t heal.
• The repair does not relieve symptoms.
• Blood vessel or nerve damage in or near the shoulder.

After Shoulder Arthroscopy

The patient is generally allowed to go home on the same day of the surgery, but with the arm in a sling, which needs to be in place for about one week or a little more depending on the intensity of the surgery. Medications are given to control the post procedure pain. Most of these procedures should be followed by physical or occupational therapy for regaining motion and strength of the shoulder and a speedy recovery. However, recovery can range anywhere from one to six months, again depending on the type of surgery, post surgery care and rehabilitation, and physical therapy.

Care Following Shoulder Arthroscopy

When you are ready to go home, your will be given a list of things to do to speed your recovery including the following.

• How long you have to wear the sling will depend on the type of shoulder repair you had. For labral repairs it’s typically worn for 4 weeks. Your surgeon will tell you if it is OK to take it off for physical therapy or grooming.

• Apply ice to the area as per surgeon’s instructions either by using an ice machine or putting ice over the bandaged area. Do not apply ice directly to the skin, put a cloth between your skin and the ice. Do not apply heat to the area. (How to make an ice bag.)

• In most cases sutures for closing the incision sites are used with absorbable sutures and does not need to be removed, otherwise, the suture removal is done within seven to ten days after surgery.

• Start eating clear liquids and soups until you see if you are nauseated. Then slowly return to your regularly diet if you’re not nauseated. Sometimes the digestive system is slow to respond after anesthesia or while taking narcotic pain medicine. If you get constipated, use a mild over-the-counter laxative.

• Strong pain pills (narcotics) may be prescribed for the first few days. Pain medicine should be taken exactly as your surgeon prescribes and as needed, but not more often than every 4 hours. Don’t wait to take your pain medicine until you are in a lot of pain; pain medicine works best if you stay ahead of the pain. Do not drink alcohol or take Tylenol while you’re taking pain medicine. You can take anti-inflammatory medicines along with the pain medicine. Take pain medicine with food to prevent an upset stomach. Call your surgeon if you have pain that is not controlled with your pain medicine.

• The bandage around the shoulder area is usually removed in about three days, however, the instructions of the physician should always be followed in this regard. Because so much fluid is used during the procedure, you may notice some bloody drainage on the dressing. If the drainage is excessive, call your surgeon. Do not touch the incisions or put anything on the incision.

• You can take a shower after the bandage is removed in about 3 days. Do not take bath until the wound has healed completely in about 10-12 days.

• Though physical therapy is usually started after one to two weeks after the surgery, some simple exercises are given to the patients to do at home just after the surgery as this helps to keep the shoulder joint mobilized.

• Do not drive until your surgeon say it’s OK; do not drive if you are taking narcotics or muscle relaxants as they can affect your ability to drive.

• If the patient’s job does not involve the affected arm, then returning to work can be within three to five days. However, if it involves the affected arm, it will take a little longer.

When to Call Your Surgeon

• If you have difficulty breathing.
• If you have increased swelling in your thigh or calf.
• If you have pain in your thigh or calf.
• If your affected arm changes color or temperature.
• If you have progressive numbness in the affected arm.
• If the pain in the affected arm gets worse even with proper use of pain medication; or if you cannot control the pain with the pain medicine.
* If you have a fever higher than 101.5°F.
• If you have excessive nausea and/or vomiting from the pain medication.
• If you have continuous draining or bleeding from the incisions.

What You Can Expect After Shoulder Arthroscopy

Shoulder arthroscopy is a better alternative to open surgery because arthroscopy is less invasive, requires a shorter hospital stay, has fewer complications and a faster recovery. Even so, the affected arm should not be exerted too much, but rather activities should be done only as tolerated.

Complete recovery can take as long as 6 months to a year depending on what type repair was done. Your return to normal depends a lot on your commitment to physical therapy and your overall health.


  1. Cindy Schmidler says:

    We are glad to hear you are feeling better after your surgery!



  3. I broke my shoulder 2 years ago due to a hard fall on a concrete floor. I went to the ERnwhereni was told they would be performing surgery. After deciding to refer me to an Ortho surgeon he decided to wait and didn’t do surgery till almost 8 months later. I had arthroscopic surgery and extensive PT. I donot deal with pain now only during strenuous overuse or cold weather. My problem I that now my shoulder protrudes forward and also upward. The bone is protruding upward considerably compared to the other which now makes it look as if one arm is longer then the other. If my arms are each at my side my left arm hangs a whole hand longer then the other which has left me feeling inconsiderably insecure and awkward. What can I do to repair this? So far the surgeons feel like it’s “no big deal” one surgeon said he could go in and clean it up again but at this point I don’t know if that is a good option. Any advice will help please.

  4. Joanne bocock says:

    I have just had a shoulder arthroscopy 2weeks ago and never known pain like it.however i have fallen down my stairs carrying a cup and saucer which i shouldnt have anyway in my good arm.i obviously couldnt put my arm out to save me.i am now in even more pain and hurt my neck and realy concerned if i have done further damage to my shoulder i dont know what to do

  5. Diane Cooper says:

    I had shoulder surgery in 2011. I believe I had a ball put in. Had no trouble until recently. Now, when I move my right arm certain ways I get sharp pain. Do I need to go back to the doc who did the surgery?:

  6. I have had surgery 2 Times on my R shoulder, 1 artho and 1 open. Both are different recovery times. Am going in soon for left shoulder . Still pain and lack of full movement in the r one .Should I wait to do the left on one done & how long?

  7. Im going to have surgery but i an addicted to speed will my doctor find out and what will he do about my surgery

  8. Hi all in need of some advise, I have had shoulder arthroscopy 5 months ago. I went for physio and did all that was required however to date I am unable to lift up my shoulder/arm. I was diagnosed a few years back with anklosing spondylitis but on a second and third opinion that diagnosis was not confirmed. My doctor has suggested that I go back into surgery were they will physically manipulate the shoulder to move as all my scans are clear and he believes that it could be a frozen shoulder. Any thoughts please

  9. Hi. I had my 4th rotator cuff surgery about a month ago. I had a large tear, shoulder instability, bone spurs, etc. Doctor worked on me and I feel ok but I am a bit worried since two of my incision sites are very sore and one stays warm/hot all the time. And there is a “knot” that I feel around of the incisions. Is that normal?? Haven’t started PT yet, doctor is keeping me in the sling longer. I can take it off when home but must have it on when out. My arm/shoulder gets tired and I feel worn out. Again is that normsl?? Any advise, input is greatly appreciated.

    Thank you.

  10. I had three years of therapy/shots/PT/chiro for a frozen shoulder (Left) and finally got arthroscopic surgery/decompression, etc. My arm is GREAT two years later. Got R side frozen shoulder in Jan. 2016 and after one shot made it worse and the pain was horrible, and with my history, I asked for the surgery on the R. side. Had it last week – manipulation under GA and subacromial decompression. He said he gave me a lot of room. I am hopeful. Not too much pain but I do wear out quickly during the day. I’m sleeping well at night. The frozen shoulder pain is gone but I don’t have great range of motion yet. I think frozen shoulder is the worst pain I have ever endured in my life. No pain has every crumpled me to the floor in tears and agony, not even childbirth.

  11. Nancy,
    Have you had any improvement? I am having the same problem. I had surgery five months ago and my arm and range of motion is worse than it was before surgery. My arm and had feel week and I have tingling and numbness in my had all the time. The doctor says “it’s probably not serious” Been going to PT for the full five months and do the exercises at home every day. I admit I am getting quite worried that I am never going to heal. I just turned 50 and am used to being quite active. The pain and numbness make me feel exhausted all the time.

  12. To Nancy the teacher, I would go back for a second opinion to another DR and tell them you are still having significant problems, and request a new mri. Because your tear may not have ever healed or have retorn or many other isses could have arose eg. Tendinitis, bursitis etc. I have had the same issues and have had 3 surgeries with 3 differrent drs. Finally found a good one. Keep going till you find a doctor that will listen and will treat I will not delay treatment. This is only my opinion, I am NOT a doctor, I just know I’ve suffered for a long time trying to get help so I know how you feel and I wish you well. Take care. And to others out there if you don’t feel improved in 12 months you need to speak to your doctor about that and if you’re not happy get a second opinion

  13. Had surgery 3 days ago shoulder decompression an removal of bone spurs an labrum clean up out of immobilizer next day PT today very sore an decedent range of motion, very scared seems very soon but all Dr. Orders.

  14. my husband had a shoulder arthroscopy and suffered a blood clot and stroke six days later , HAS ANYONE ELSE HAD SIMILAR EXPERIENCE OR ANY ADVISE PLEASE ,

  15. adalia perez says:

    I have blood specks under my left eye after my rotor cuff surgery what does that mean

  16. Does PRP shot work for torn labrum in shoulder?

  17. I had arthroscopy to fix a rotator cuff tear 2 years ago,. I went through 6 months of physical therapy, but it just didn’t seem to be getting any better. I am a teacher, and sometimes I have to hold my right hand up with my left hand, so that I can write on the board. My right arm is fairly useless when it comes to lifting anything, or raising it for very long. Consequently, I think that I have over-extended my left shoulder, trying to cover for the right one. I am VERY worried about this. I have always been VERY strong , and it’s killing me to be somewhat helpless. I’m afraid to have surgery on my left arm, because me right one never really got better. I’m envious of people who say that they got their full use back. I am 64. Does age matter?

  18. Lorraine azar says:

    What does it mean to have arthritis cleaned out during shoulder surgery?

  19. I had a sub acrominal decompression in march having suffered with shoulder pain for two year, had several cortisone injections and hydo injections that inserts saline into the joint to expand it. 5 months on, I am in more pain now than before, my arm is just so weak, if I am laying down I cannot lift my arm up. Have done physio, I now have movement and can lift my arm up if I use my other arm to do it, I can put my arm behind my back, but the pain is still there. Mornings are the worst, my arm is numb during the night and it just doesn’t want to move if I don’t move it with my other arm, once I am up and have a shower, movement comes back, not sure if it’s the cold and the non movement during the night, but I am wits ends and can’t understand why I am in so much pain, if I had an operation to fix the problem in the first place. Am now trying reflexology and will try acupuncture as well.

  20. Darlene LeBlanc says:

    I had arthroscopic surgery on my shoulder for impingement 10 years ago and the shoulder is really sore again. The doctor here told me that nothing can be done for the pain. He says that a second surgery is not possible due to the scar tissue and that the larger surgery would not help the pain or movement that I have now. Any suggestions on what I can do to relieve this pain? All pain meds do not work for me. I had 4 hip replacements with no success and have tried many meds and really extreme high doses that do not do anything for the pain.

  21. I have two completely torn tendons, supposed to have surgery, but don’t know when. Apparently a long wait. In the meantime is it a wise choice to continue with physiotherapy, and exercise the shoulder 3 times a day? Does this better prepare a person for surgery?

  22. I had a Arthroscopy done yesterday now I noticed that I have like blood specks in both of my eyes and I’m worried

  23. Had the surgery to repair rotator cuff tear, 10 days ago. Arm feels great , no pain, but being a 1 arm person is driving me nuts. Started phyiscal therepy last week with some passive exercises, and I’m ready for more. Don’t see Doc for another week and this immobilizer is driving me nuts. I feel very confined. Will ask Doc if I can return to work. Every thing I read says the first 4 to 6 weeks are the worse, then you start to build ROM, and strength in your shoulder. Sleeping is a challenge, not for pain, but just being tired enough from not doing anything all day. Good luck.

  24. i have had a rotator cuff tear in a 4 wheeler accident 3 years ago no pain what so ever and full rom now i am doing the other shoulder i had the surgery 3 days ago and am off the pain meds because i wear the pillow immobilizer and will be back up in running in no time following the proper stretching and no lifting for at least 4 to6 weeks and am sure to have a healthy recovery

  25. Media Partners says:

    Geesh, that’s not good to hear. Do they say how long it will take to get back to some sense of normal? I’m starting to have rotator issues and have started trying to find ways to prevent surgery.

  26. Hey, 4 years ago i dislocated my shoulder playing football for portland.state, i thougjt nothing of it do to it going strait back in socket and only hurting a little, that was my sr year, sence then iv dislocated my arm over 50 times, river rafting, working, sleeping, picking up my son. I delt with the pain and didnt see a doc, on thanksgiving of 2012, i woke up and STRETCHED my arms over my head, my shoulder went rip rip snap, it woke my wife up it was such a loud popping sound, after 30 minutes running around the house screaming my wife finaly drove me to the hospital, i was use to my shoulder relocating like the preveas 50 times, it didnt!!!!! The er put me to sleep to put my arm in socket, after seeing a surgen, i had my surgery 3 weeks ago, 6 incitions,i have metal ancers holding my legaments to my bone, and had rotator cuff tear, i still cant sleep at nite, im a grown man and im still getting tears n my eyes n the mornings after i finaly fall asleep sitting up, i keep telling myself i would of never did this surgery if i knew how much pain afterwards was going to bring, my advise to u is do NOT lift with your shoulder a month after surgery!

  27. I work in cleaning buildnings. I’m going to surgery shoulder arthroscopy in 2 weeks. I like to know if i can back to work in 2 or 3 weeks , and if I can use the vacuum or any heavy machine. Please tell me how bad is this surgery and the recovery.


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