Shoulder arthroscopy is a method of performing a surgical procedure involving the endoscopy of the shoulder joint area. The operator makes minimal incisions through which he introduces a camera (arthroscope) and surgical instruments. Arthroscopy enables effective treatment of many diseases and injuries of the shoulder, e.g. sub-shoulder tightness, rotator cuff injuries or instability of the shoulder and shoulder-clavicular joints. Arthroscopy is a minimally invasive procedure, thanks to which the patient leaves the hospital the very next day after the surgery.

Before qualifying for surgery, shoulder pain should be thoroughly diagnosed by an orthopedist. Clinical tests and imaging tests allow to determine the severity of degenerative changes and / or the extent of shoulder injuries. Surgery is performed if the identified changes hinder sports or professional activity, do not undergo rehabilitation treatment, or a shoulder injury can only be treated surgically. When planning treatment, the doctor also takes into account the patient's expectations regarding the level of shoulder fitness and readiness to undertake rehabilitation after the procedure.

The time of rehabilitation after shoulder arthroscopy depends on the extent of shoulder injuries, the type of procedures performed during arthroscopy and the patient's level of activity. Minor repairs of the shoulder structures are associated with several weeks of rehabilitation, other more extensive treatments require regular participation in rehabilitation for up to several months. It is worth noting that the recovery period is always shorter compared to open shoulder surgery.

The rotator cuff, also known as the hood or the rotator cuff, is a group of muscles that surround the head of the humerus. They are responsible for the stabilization of the humerus in the acetabulum of the scapula and for movements in the shoulder joint (mainly abduction movements and rotations).

Tendon damage is often caused by falling on a straightened limb or when lifting a heavy object while rotating the arm. People who actively practice sports (especially those disciplines that require frequent lifting of hands, e.g. retina) and people who perform physical work that require frequent repetition of the same movements, causing microtrauma and overload in the tendons of the rotator cuff, are also exposed to damage to the rotator cuff tendon.

Patients experience a decline in muscle strength and pain, often described as stabbing, appearing around the top of the shoulder and sometimes radiating down to the forearm. Pain can also appear when you are resting - for example, while you are sleeping. Patients may find it difficult to move the limb, especially raising the arm to the side.

Patients who are usually qualified for the surgery are those who have not been successful in conservative treatment, as well as those who are active in sports, in whom damage to the rotator cuff is the result of acute trauma. The surgical procedure is also indicated when the damage is so extensive that it prevents normal functioning and may contribute to the formation of secondary overload changes in the shoulder.

The operation of the rotator cuff usually consists in suturing - with the use of special anchors and sutures - the tendons in their anatomical position.
The treatment may include the following methods:

classical (open) reconstruction of the rotator cuff
minimally invasive rotator cuff surgery - mini-open procedure
arthroscopic removal of calcification of the rotator cuff
arthroscopic reconstruction of the rotator cuff

Shoulder instability is a condition in which the head of the humerus is displaced relative to the acetabulum. Recurrent slipping of the humerus head out of the acetabulum is called chronic shoulder instability.

The symptom of a dislocation in the shoulder joint is stinging and sharp pain in the shoulder area. People with a dislocated shoulder joint have problems with moving the arm, and distortion of the outline around the shoulder can often be observed. Accurate diagnosis of the injury should be performed by an orthopedic surgeon.

After a shoulder dislocation, conservative treatment is undertaken in most cases. When the dislocation is accompanied by severe damage to the labrum and / or the acetabulum of the scapula, surgical treatment is required. The orthopedic doctor makes the final decision regarding the choice of treatment.

In the case of damage to the labrum of the acetabulum, it is necessary to undergo surgical treatment. Surgery is also necessary if the damage is extensive or the dislocation is habitual.

The aim of the operation is to reattach the acetabular labrum in its anatomical place. Depending on the type of injury, anatomical conditions and the degree of labral damage, the operation can be performed arthroscopically or with the classic opening of the joint.

The return to full fitness takes place within 6 to 9 months after the surgery.

Symptoms, including pain, the feeling of skipping the shoulder blade, and the presence of an audible click when moving the shoulder may be a sign of the so-called snapping scapula syndrome. The cause of the disease is structural changes leading to a mechanical conflict of the bone or soft tissues lying under the scapula. Pain under the scapula without the feeling of skipping may be related to the inflammation of the subscapular bursa. In order to determine the cause of the ailments, you should go to an orthopedist who will perform a detailed clinical examination and order additional imaging tests. Early diagnosis and treatment of "popping scapulae syndrome" is very important - ignoring the symptoms can lead to a progression of structural changes that can only be treated with surgery.

The main goal of rehabilitation is to restore the correct movement patterns of the scapula, which will not overload the tissues lying in the subscapular area. The first stage of physiotherapy includes methods to normalize muscle tension and to extend the shortened muscles to restore the normal mobility (mobility) of the shoulder blade. The crackling scapula exercises involve activating the appropriate muscles to achieve the required scapula stabilization. Gradually, the patterns of the entire upper limb are included, while maintaining the correct biomechanics of the scapula and the shoulder joint. The last stage of rehabilitation is strength and endurance exercises of the upper limb and elements of the sports discipline. The therapy process should be carried out under the supervision of an experienced physiotherapist.

The indication for surgical treatment is the presence of degenerative-productive bone changes, free bodies in the scapulo-costal space and other pathologies that cannot be rehabilitated. The most common procedure is the excision of the bone growths of the upper or lower edge of the scapula and the release of connective tissue adhesions that cause jumping and pain under the scapula. If necessary, the pathologically thickened synovial bursa are also removed.