Complications of Arthroscopic Shoulder Surgery

Possible Complications Associated With a Shoulder Scope

Shoulder arthroscopy is a surgical procedure often performed for minimally invasive treatment of a number of different conditions.  Shoulder arthroscopy is ofter performed for treatment of rotator cuff tears, labral tears, and shoulder bursitis.  Arthroscopic procedures are also sometimes used for treatment of early shoulder arthritis.

While shoulder arthroscopy is considered a very safe surgical procedure, there are possible complications that should be considered before undergoing surgery for treatment of your condition.  Patients should be aware of the possible complications, and the likelihood of these complications occurring. 

1
Infection

shoulder pain
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Infection is a serious concern whenever having surgery, whether a major surgical procedure, or a minor treatment.  Bacteria are present on our skin and in the environment, and even with great caution, there is a chance of developing an infection anytime you have surgery.

Shoulder surgeries are prone to developing common skin bacteria infections such as staph and strep--the most common types of surgical infections.  In addition, a less common bacteria called Propionibacterium acnes is often associated with shoulder infections.  P. acnes is present on the skin around the shoulder, and can be difficult to detect by standard tests for bacterial infection.

There are steps that you can take to help prevent surgical infections.  Treatment of infections may require additional surgical procedures and long-term antibiotics, so it is worthwhile for patients to take these steps to help prevent chances of infection.

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2
Nerve Injury

Patient explaining shoulder pain to doctor
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Nerve injury is uncommon, but with the number of major nerves that surround the shoulder joint, this is a possible complication of surgery.  When work is required at the bottom of the shoulder (the inferior capsule or labrum) there is a particular concern of injury to the nerves.  Nerves can either be injured by instruments working inside the shoulder joint, or by inserting the instruments too close to nerves that surround the shoulder joint.

3
Frozen Shoulder

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One of the most common problems after shoulder surgery is stiffness of the shoulder joint.  For some surgical procedures, a period of time of immobilization is necessary to allow for adequate healing.  However, immobilization of the joint can also cause patients to develop a condition called a frozen shoulder.

Patients who develop a frozen shoulder have excessive scar tissue form in the shoulder joint capsule, the tissue that surrounds the ball-and-socket shoulder joint.  Frozen shoulder is generally treated with aggressive therapy and sometimes a cortisone injection.  Many cases of frozen shoulder take months or longer to resolve.

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4
Chondrolysis

Chondrolysis is a rare but potentially serious complication of shoulder arthroscopy.  Chondrolysis causes damage to the cartilage of the joint surface and can lead to early progression of arthritis of the joint.  This is especially problematic for young patients who develop this condition after treatment of an athletic injury.  Typically, the expectation of these patients is to restore full function of the shoulder, and chondrolysis can lead to permanent problems with the shoulder joint if the cartilage is badly damaged.

Fortunately, chondrolysis is a very rare complication, and surgeons have learns precautions to take to help prevent this potentially serious complication.

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5
Head/Neck Injury

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One of the challenges of shoulder surgery is the locations of the joint.  Surgical drapes cover the head and neck area during the surgery to prevent contamination and infection, but this can limit the ability to see the head and neck by the anesthesiologist.  Surgeons must take great care to protect and support the head and neck to ensure there are no injuries as a result of poor patient positioning. 

Sources:

Moen TC, et al. "Complications of Shoulder Arthroscopy" J Am Acad Orthop Surg July 2014 vol. 22 no. 7 410-419.

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