Arthroscopic Treatment of Shoulder Arthritis
Shoulder replacement has a successful track record for the treatment of shoulder arthritis. Survival rates are very good for these implants however, the components used to replace the shoulder joint are at risk of loosening or wearing out with use prolonged/excessive use. Dr. Lenarz therefore tries to avoid these complications through the use of less invasive arthroscopic procedures in appropriately selected patients. These procedure are performed as to salvage the joint present rather than replace it. Dr. Lenarz may perform an outpatient arthroscopic procedure for the arthritic shoulder.
The arthroscopic procedure can be done at the hospital or an outpatient surgical center. Through very small incisions, Dr Lenarz inserts small instruments into the shoulder including a camera. The entire shoulder is inspected under direct visualization with this camera and any damage that may not have been noted on an MRI will be addressed appropriately.
Arthroscopic procedures can be done in patients with mild to moderate shoulder arthritis with success. This procedure typically involves removal of the osteophytes (bone spurs), release of the contractures of the capsule and removal of any loose cartilage fragments. This is usually referred to as an arthroscopic debridement and capsular release. Often, the biceps is damaged with arthritis as well and this damaged tendon causes a significant amount of the pain experienced. Dr. Lenarz will often also perform a biceps tenodesis to remove the damaged segment of the tendon and re-attach the tendon to the bone. This is also done arthroscopically.
Additionally, with advanced degenerative change, Dr. Lenarz can perform arthroscopic biologic resurfacing of the joint using osteochondral allografts from cadaver bone and cartilage.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation, the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Once the block wears off, mobilization of the arm may begin. The dressing may be removed and the patient may shower the day following surgery. The patient is asked to NOT scrub the incisions but allow water to wash over them. If a biceps tenodesis was performed the arm may be removed from the sling and moved to tolerance. The only limitation initially is a lifting restriction of 5 pounds with the biceps on the operative arm. This restriction should be observed for the first 6 weeks post-operatively.