Scope Arthritis
An arthritic shoulder causes you much pain. Over time the cartilage that covers the ends of the ball and socket has worn away. Instead of the cartilage cushioning the ends of the bone, you have raw bone rubbing against raw bone. Since this is painful you naturally limit the use of your arm and then scar tissue can develop. Scar tissue is a tough, gristle like, tissue that has formed deep in your shoulder and affects the ligaments and tendons. |
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These tendons and ligaments should be elastic and stretch as you move your shoulder. The scar tissue prevents this and further limits the movement of your shoulder.
Treatments other than surgery are available, including just living with the condition, physical therapy exercises, medication or injections, but Dr. Gartsman does not believe these are reliable alternatives. If surgery is not performed, your condition will probably worsen slowly over time.
The Surgery Experience
The purpose of the surgery is first to remove the scar tissue and lengthen any ligaments and tendons that have tightened so that your shoulder can move more easily. More space is created between the ball and the socket by removing a thin layer of bone. This operation uses the arthroscope and two or three 1/2” incisions.
The surgery is completed as an outpatient procedure using general anesthesia. You also are given an injection of novocaine to decrease the pain in your shoulder after surgery. The injection will be placed in the side of your neck just above your collarbone.
You will awaken in the recovery room after your surgery with your arm supported with a pillow. An ice pack will cover your shoulder to help control the pain and swelling.
How successful is the surgery?
No shoulder operation is 100% successful in every individual but the procedures we perform are reliable and will help restore the potential function in your shoulder. The operation is most successful at relieving pain. What is harder to accomplish is the return to overhead use of the arm in work and/or sports. Because of the many variables involved, I can make no guarantees other than to assure you I will deliver the very best medical care possible.
Doctor’s Visits
Your first office visit is two weeks after surgery so that Dr. Gartsman can examine the surgical incision. He will give you additional instructions for exercises and discuss your allowed activity level. Six weeks after surgery, more vigorous use of the shoulder will be allowed. Office visits then occur three, six and 12 months after your surgery.
Returning to Work
For most sedentary jobs, Dr. Gartsman recommends taking one to two weeks off from work. When you return to work you should be able to manage as long as you do no lifting, pushing, pulling or carrying. Most patients can start light duty work involving no lifting, pushing, pulling or carrying more than one to two pounds, two weeks after surgery. Work at waist level and 5-10 pounds of lifting is started two months after surgery, but you will generally need three to six months of recovery before beginning occasional work at shoulder level. Return to heavy lifting or overhead use may require 6-12 months.
Rehabilitation
A major goal of this operation is cartilage growth and continuous passive motion
promotes cartilage. You will be examined two weeks after surgery to determine if you need physical therapy (only about 10% of patients require regular visits to a physical therapist).
Following surgery, you will use a machine called a Continuous Passive Motion (CPM) chair to move your arm in the correct movement. You will use this at home for 2 weeks after the operation. (delivery and pickup will be arranged). Patients use the chair one hour, four times a day. Use the ice pack for one hour after each chair session. Doctor visits will continue for six weeks after surgery, as well as visits to the therapist for additional exercises. At the three-month visit, you will begin strengthening exercises.
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