Arthroscopic Shoulder Surgery Wins over Skeptics

 Spring is here and the warmer weather means gardening, golf, spring cleaning and many other physical activities. But if a bum shoulder hinders motion, it may be a good time to look into arthroscopic surgery.

“It’s hard to imagine that only a few short years ago all shoulder repair surgeries were performed with large, wide-open wounds,” said Michael Chrissos, MD, a board-certified orthopedic surgeon with Michigan Ortho­pedic Center on the campus of St. Joseph Mercy Ann Arbor. “The vast majority of shoulder repairs — some 99 percent — are performed arthroscopically.

There is far less pain, blood loss and muscle trauma, and a much smaller scar.”

Recovery is tricky because, according to Chrissos, patients feel so good right after surgery they try to do too much too soon. “It’s critical patients understand that the healing process takes time,” he cautions. “This pro­cedure not only relieves the shoulder pain, it vastly improves their range of motion. But it takes time.”

When arthroscopy first became available, Chrissos, saw opportunity to be in on the ground floor of a wide-spread revolution. “At first there was a lot of resistance and plenty of skepticism,” he said, “and there should have been. When something new is introduced, you want to be sure it’s proven; but I knew intuitively that this technique was going to meet—or surpass—the results of open surgery.”

Stretching the boundaries of the technology that was available at the time, he and a colleague, Dr. John Morris, actually worked with a local engineer to design a prototype that vastly improved the suturing process. “They designed a special needle that would load, push through and pull back in the tiny little incision,” he said. The patented product was refined and manufactured. Chrissos uses anchors to hold the sutures, comprised of an inert plastic that most patients seem to tolerate well.

There’s a misconception between joint replacement and arthroscopic surgery. “It’s important to note that when I’m talking about arthroscopic shoulder surgery, I’m not talking about shoulder joint replacements. I am referring to repairing torn or damaged tendons, ligaments and cartilage,” he said. “Because we insert a camera during surgery we can see 360 degrees, and have a much better view of what we’re doing verses traditional open surgery,” said Dr. Chrissos. “There’s also less risk of infection and less stiffness.”

Arthroscopy:  Sometimes called “key hole” surgery, arthroscopy is a minimally invasive procedure performed via small incisions using specially designed instruments and a viewing scope that is inserted into the affected area and projects images onto monitors in the operating room.

Candidates for shoulder repair generally fall into two categories:

• Under 40 years of age, who have suffered some kind of trauma— young athletes, accident victims or other injury sufferers
• Over 40 years of age, with an accumulation of wear-and-tear from general use, arthritis or other underlying condition

“Tremendous strides have been made with arthroscopic shoulder surgery, that Dr. Chrissos wants patients and referring physicians to know that there is no need to delay. “Early evaluation is critical and we can avoid complications and worse outcomes with timely intervention.”