This document provides information about shoulder arthroscopic stabilization surgery. It describes how arthroscopy uses small incisions and a camera to view the inside of the shoulder joint. During surgery, torn ligaments and labrum from shoulder dislocations are reattached to the shoulder bone using suture anchors to stabilize the joint and prevent further dislocations. The recovery process involves wearing a sling for 6 weeks followed by strengthening exercises, with a full return to activities in 4-6 months.

1. Shoulder Arthroscopic Stabilisation.
Information for patients.
Dr Geoffrey Smith
Anatomic images courtesy of www.biodigital.com

2. What is shoulder arthroscopy?
• Keyhole surgery of the
shoulder joint.
• Many conditions are amenable
to arthroscopic treatment
• Usually performed under
general anaesthetic (asleep).
• An additional local anaesthetic
nerve block may be used
• The patient is then carefully
positioned on a special
operating table

3. What happens?
• Several small (0.5cm) incisions are made
• A camera and other instruments are inserted
• The camera has an angled lens which can be
rotated around to give a view all around
• We also change the camera position to get the
best possible view and angle for out working
instruments
• Visualisation is improved by running fluid into the
shoulder

4. Bones
• The shoulder
(glenohumeral joint) is
a ball and socket joint.
• The ball is at the top of
the arm bone (the
humerus).
• The socket is the
glenoid which is part
of the shoulder blade
(scapula).
Humerus Scapula

5. Glenoid
• The glenoid bone is
pear shaped
• It is surrounded by
a rim of cartilage
(the labrum)
• The biceps tendon
attaches to the
labrum at the top
of the glenoid
Labrum Biceps
Glenoid

6. Soft tissue
• The glenohumeral joint
is surrounded by a
sleeve of tissue (the
capsule).
• The capsule is thick in
places & forms
ligaments.
Capsule

7. What happens when a shoulder dislocates?
• Viewing from underneath
the glenohumeral joint
looks like a golf ball sitting
on a golf tee
• The labrum and capsule
stop the ball of the
humeral head falling off
the glenoid (the tee)

8. What happens when a shoulder dislocates?
• The labrum and capsule
are detached from the
glenoid
• The soft bone of the
humeral head is crushed
down by the corner of the
glenoid
• This compression fracture
is called a ‘Hill-Sachs’
lesion

9. What happens when a shoulder dislocates?
• When the shoulder is put
back in place the labrum
and the capsule stay
detached from the
glenoid
• The Hill-Sachs lesion is
still present
• These injuries result in a
predisposition to
recurrent dislocations

10. Repair
• This arthroscopic picture
is taken viewing the
shoulder from behind
• The labrum is normal
• In this picture the labral
detachment is easily seen

11. Repair
• The camera has now
been moved so that the
back of the humerus can
be evaluated
• The Hill-Sachs lesion can
be seen
• Most repairs involve
reattachment of the
labrum to the glenoid
• The Hill-Sachs lesion
usually does not need to
be treated

12. Repair
• The torn labrum and
capsule are grasped with
strong suture material
• The suture is passed
through the eyelet of an
anchor
• The anchor is inserted into
a drill hole in the glenoid
• Several anchors are used to
complete the repair
Anchor
Completed repair

13. After Surgery
• You usually go home on the same day or the
day after surgery
• A sling is worn for 6 weeks
• Strengthening is allowed after 6 weeks
• A return to full activities is expected after 4-6
months