Arthroscopy simply means 'telescopic' or 'keyhole' surgery in a joint. Shoulder arthroscopy is now the standard approach used to examine your shoulder joint, your acromioclavicular joint and your subacromial space. Many surgical procedures can now be achieved arthroscopically, including decompression, rotator cuff repair and shoulder stabilisation.
Advantages of arthroscopy over open surgery include: less scarring; less muscle damage; a better view of the structures inside the joint and access to areas of the joint that are traditionally hard to reach via open approaches. Also, the risk of infection after keyhole surgery is much lower than after open surgery and nerve damage and bleeding are also very rare with keyhole techniques. Modern instruments and implants allow us to achieve reliable reconstructions arthroscopically with outcomes as good, or better than via open techniques.
Shoulder arthroscopy can be performed either with you lying on your side, or with you sitting up as if in a deck chair. Tiny incisions are made around your shoulder to allow the telescope and instruments to be manoeuvred inside your joint. During arthroscopic surgery sterile saline is run through your shoulder to widen the joint space and keep the view clear. Some of the fluid is absorbed and this causes your shoulder region to swell during the operation. This swelling subsides in the first few hours after your operation and fluid will also leak out from your wounds. A padded dressing is therefore applied at the end of your operation to absorb this leakage. Arthroscopic scars heal very well and over time become barely visible.
Below are some photographs and short videos of shoulder arthroscopy. I hope they help you to understand where your particular problem fits in.
Initial view of the glenohumeral joint of a right shoulder on insertion of the arthroscope from the posterior portal.
Labrum = this cartilage rim is attached all around the glenoid edge. In dislocations it is most commonly ripped off from the anrtero-inferior region, but can be damaged anywhere.
MGHL = middle glenohumeral ligament. This is a fold of shoulder capsule that becomes tight as the shoulder is moved outwards. Its appearance varies between individuals.
Subscap = tendon of the Subscapularis muscle. This tendon inserts onto the front of your humeral head (the lesser tuberosity). The muscle internally rotates the shoulder.
The long head of biceps tendon arises from the top of your glenoid (socket) and runs inside the shoulder joint before entering its groove at the front of your humerus (arm bone)
The front of the shoulder joint shows the subscapularis tendon's insertion onto the humeral head. This muscle is the most powerful of the rotator cuff: it internally rotates your shoulder.
The biceps pulley acts as a sling for your biceps tendon as it leaves the joint in its groove.
The capsule of the rotator interval is normally thin and supple. In front of it (therefore not seen) lies the coracoid process of the scapula
Moving the scope over the top of the humeral head one can see the undersurface of the supraspinatus and infraspinatus tendons of the rotator cuff. These are the most commonly affected tendons in rotator cuff disease.
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
A very pleasant Consultant who knows exactly how to make pain go away.
Mr Granville - Chapman has an excellent bedside manner. He engaged with my 12 year old son at an appropriate level and took the time to ensure that he understood the procedure and answer all his questions. He is thoroughly professional and I would not hesitate to recommend him.
I have been very pleased with the attention I have received. Mr. Granville-Chapman has reassured me that my symptoms are normal. It is very easy to make appointments that suit me.
Mr Granville chapman I found be caring informative and professional I would recommend him to all if you have a problem don't hesitate to contact him you won't be disappointed.
I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
So far my experience with Mr Jeremy Granville-Chapman has been personal and informative with regard to the operation I will be having. I feel confident that my operation will be a success and for this reason I am very happy to have Mr Jeremy Granville-Chapman as my consultant.
Very knowledgeable and helpful. Takes the time to make sure you're getting the treatment you need.
Mr Jeremy Granville -Chapman is not only a highly skilled consultant but is able to put you straight away at ease .My appointments were arranged very swiftly which was great, when you are experiencing severe pain. I am very happy with my treatment so far . many thanks to everyone who was involved in my treatment.
Polite, helpful, professional. Makes an effort to ensure full understanding of issues and procedures to be done. Highly satisfied
Very pleasant. Clear, careful explanations & options/possibilities. I feel well informed, and happy that my concerns are being well addressed, with a plan of review of the symptoms.
Excellent advise with everything explained clearly and a successful treatment which has benefited be greatly.
Spire Thames Valley hospital
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