Shoulder Arthroscopy: Surgery, Recovery, and Risks

Shoulder arthroscopy is a minimally invasive procedure that allows a surgeon to examine the inside of the joint and treat certain injuries through small incisions. The surgeon inserts a thin camera called an arthroscope, which sends high-definition images to a monitor.

Small surgical instruments are introduced through additional incisions to repair injured tendons, ligaments, cartilage, or other structures. Although the incisions are smaller than those used in open surgery, the repaired tissues may take several months to heal, especially after rotator cuff or labral repair.

Not every shoulder condition requires arthroscopy. Before recommending surgery, an Orthopedics and Traumatology specialist should confirm the diagnosis and discuss the expected benefits, risks, and available alternatives.

Today, shoulder arthroscopy is mainly used to treat injuries identified through a medical history, physical examination, and imaging studies such as X-rays, ultrasound, or magnetic resonance imaging.

In selected cases, it may also help confirm findings that were unclear on imaging. However, it is not usually the first diagnostic test for shoulder pain.

Conditions that may be treated with arthroscopy include:

• Rotator cuff tears.
• Labral tears.
• Recurrent shoulder instability or dislocations.
• Bankart lesions.
• SLAP tears.
• Selected conditions affecting the biceps tendon.
• Inflammation of the synovial lining.
• Shoulder stiffness caused by adhesions or capsular tightness.
• Loose pieces of cartilage or bone.
• Certain acromioclavicular joint conditions.
• Selected causes of subacromial pain.

The appropriate procedure depends on the injury, the patient’s age and activities, tissue quality, and treatments already attempted.

No. Many shoulder conditions improve without surgery, particularly when there is no major traumatic tear, recurrent instability, or significant loss of function.

Initial treatment may include:

• Temporary activity modification.
• Physical therapy.
• Therapeutic exercises.
• Ice application.
• Pain relievers or anti-inflammatory medication when medically appropriate.
• Injections in selected cases.
• Management of medical conditions that may affect recovery.

Surgery may be considered when pain or functional limitations continue despite appropriate nonsurgical treatment, when the injury is unlikely to heal on its own, or when delaying treatment could make repair more difficult.

An orthopedic specialist may consider arthroscopy when a patient has:

• Persistent pain that does not improve with treatment.
• Weakness that makes it difficult to raise or use the arm.
• A traumatic rotator cuff tear.
• Repeated shoulder dislocations.
• A feeling that the shoulder is unstable or “slips out.”
• A labral injury that affects function.
• Painful catching, locking, or loose fragments.
• Significant loss of movement.
• An injury that interferes with sleep, work, or sports.

An abnormality on an MRI does not automatically mean surgery is necessary. Imaging findings must be evaluated alongside the patient’s symptoms and physical examination.

The rotator cuff is a group of tendons that helps move and stabilize the shoulder. When a tendon separates from the bone, the surgeon may reattach it using sutures and small anchors.

These anchors may be made of metal, plastic, or bioabsorbable materials and usually do not need to be removed.

A Bankart lesion is a tear in the anteroinferior portion of the labrum, the ring of tissue surrounding the shoulder socket. It commonly occurs after an anterior shoulder dislocation.

During arthroscopy, the surgeon may repair the labrum and tighten the injured ligaments to improve stability. If there is substantial bone loss, an isolated arthroscopic repair may not be sufficient, and another type of operation may be necessary.

A SLAP tear affects the upper part of the labrum from front to back. The long head of the biceps tendon also attaches to this area.

Treatment may include:

• Removing damaged tissue.
• Repairing the labrum.
• Treating the biceps tendon.
• Performing a biceps tenodesis in selected patients.

The decision depends on the patient’s age, type of injury, symptoms, and athletic or occupational demands.

In selected patients, the surgeon may remove inflamed tissue from the area above the rotator cuff. An acromioplasty may also be performed to reshape part of the acromion when there is a specific indication.

A bone spur is an overgrowth of bone, not a tumor. Acromioplasty is also not routinely necessary during every rotator cuff repair. Its potential benefit should be assessed according to each patient’s anatomy and surgical findings.

Before surgery, the specialist will review:

• Symptoms and how the injury occurred.
• Imaging results.
• Chronic medical conditions.
• Previous operations.
• Allergies.
• Medications and supplements.
• Tobacco, alcohol, or cannabis use.
• Previous reactions to anesthesia.
• Work and athletic activities.

Tell your medical team if you take blood thinners, aspirin, anti-inflammatory medication, diabetes medication, or herbal supplements. Do not stop any treatment without medical instructions.

Fasting requirements depend on the type of anesthesia and the hospital’s protocol. Follow the specific instructions provided by your surgeon and anesthesiologist.

It is also helpful to:

• Arrange for someone to drive you home.
• Ask someone to assist you during the first few hours.
• Bring a loose or button-down shirt.
• Place frequently used items within easy reach at home.
• Learn how to use your sling.
• Understand the initial pain-control plan.

The procedure generally involves the following steps:

1. Anesthesia is administered.
2. The patient is positioned to give the surgeon access to the shoulder.
3. Sterile fluid is introduced to expand the joint.
4. The arthroscope is inserted through a small incision.
5. The tendons, ligaments, cartilage, labrum, and bones are examined.
6. Surgical instruments are introduced through additional small openings.
7. Damaged tissue is repaired or removed.
8. The incisions are closed and covered with dressings.

General anesthesia, a regional nerve block, or a combination of both may be used. A nerve block can provide pain relief for several hours but may also temporarily numb the arm.

The duration depends on what needs to be repaired. A simple procedure may take less than an hour, while extensive rotator cuff, labral, or combined repairs may take longer.

Time for anesthesia preparation and postoperative monitoring must also be considered.

Many arthroscopic procedures are performed on an outpatient basis. Patients may go home the same day when they:

• Have recovered adequately from anesthesia.
• Have acceptable pain control.
• Can walk safely.
• Can tolerate fluids.
• Do not have severe nausea.
• Meet the medical team’s discharge requirements.

Although the incisions are small, tendons and ligaments still require time to heal. Recovery after a simple debridement is very different from recovery after a rotator cuff repair.

Recovery may take several weeks to six months or longer. After a large repair or before returning to high-demand sports, rehabilitation may take 6 to 12 months.

Recovery depends on:

• The type and size of the injury.
• The procedure performed.
• Tendon and bone quality.
• Age and general health.
• Tobacco use.
• Diabetes control.
• Adherence to rehabilitation.
• Occupational or athletic demands.

After a minor procedure, a sling may only be needed for a few days. Following a tendon or labral repair, it may be required for four to six weeks or longer.

The sling protects the repaired tissue during early healing. Removing it too soon or actively using the arm without authorization could compromise the repair.

The orthopedic surgeon must determine the appropriate duration.

Rehabilitation is an essential part of treatment. It should progress gradually while respecting the biological healing time of the repaired tissues.

The rehabilitation program may include:

• Protection of the repair.
• Controlled passive movement.
• Gradual restoration of mobility.
• Active movement.
• Strengthening.
• Return to work or sports.

Take medication exactly as prescribed. Applying ice may reduce pain and swelling, but a barrier should always be placed between the ice and the skin.

If you received a nerve block, follow the safety precautions provided by the medical team while the arm remains numb.

Keep the dressings clean and dry for the period indicated. Do not submerge the shoulder in a bathtub, swimming pool, or the ocean until the incisions have healed and the surgeon approves it.

During the first few days, sleeping in a semi-reclined position may be more comfortable. Pillows can be used to support the arm. Avoid sleeping on the operated shoulder until your surgeon says it is safe.

Do not drive while:

• Wearing a sling.
• Taking sedating medication.
• Unable to control the steering wheel safely.
• Experiencing limited strength or movement.
• Waiting for medical clearance.

The timing depends on the procedure and the physical demands of the job.

Office work may be resumed within days or weeks if pain is controlled and the patient can work safely. Jobs involving lifting, pushing, pulling, or overhead activity may require several months of recovery.

Closed incisions do not mean the internal tissues have completely healed.

Shoulder arthroscopy is generally safe, but every operation has risks. Possible complications include:

• Infection.
• Bleeding.
• Reactions to anesthesia.
• Nerve or blood vessel injury.
• Shoulder stiffness.
• Blood clots, which are uncommon.
• Persistent pain.
• Failure of the tendon to heal.
• Recurrent rotator cuff tear.
• Recurrent shoulder instability.
• The need for another operation.

Individual risk may be higher in people who smoke or have poorly controlled diabetes, obesity, cardiovascular disease, poor tissue quality, or difficulty following postoperative restrictions.

Contact your medical team if you experience:

• Pain that worsens or does not respond to medication.
• Fever.
• Increasing redness.
• Drainage from an incision.
• Excessive swelling.
• Numbness that lasts longer than expected.
• A cold, pale, or blue hand.
• Persistent vomiting.
• Adverse effects from medication.

Seek emergency care for difficulty breathing, chest pain, fainting, significant bleeding, or a sudden loss of sensation or circulation in the arm.

Seek immediate care after a fall, impact, or accident if you have:

• A visible deformity.
• Severe pain.
• Inability to move the arm.
• An open wound.
• Loss of sensation.
• A cold, pale, or blue hand.
• Sudden weakness.
• A suspected fracture or dislocation.

Do not attempt to put a dislocated shoulder back into place yourself.

At BlueNetHospitals Los Cabos, an Orthopedics and Traumatology specialist can evaluate your shoulder, request appropriate imaging studies, and determine whether you need physical therapy, medical treatment, or arthroscopic surgery.

A surgical recommendation should be based on an accurate diagnosis and your functional needs—not solely on an MRI result.

If you have persistent shoulder pain, weakness, recurrent dislocations, or difficulty moving your arm, schedule an appointment with our Orthopedics and Traumatology  team.

📲 Appointments via WhatsApp: +52 (624) 151 0693

If you have suffered an accident or have severe pain, deformity, or loss of sensation:

📞 24-hour Emergency Department: +52 (624) 1043 911

This content is for educational purposes and does not replace a medical evaluation.

It is a minimally invasive operation in which a small camera is inserted through small incisions to examine and treat injuries inside the shoulder.

It is performed by an orthopedic surgeon, preferably one with experience in shoulder surgery and arthroscopy.

No. Diagnosis usually begins with a medical evaluation and imaging studies. Arthroscopy is mainly used to treat selected injuries.

It may be used to treat rotator cuff tears, labral injuries, instability, Bankart lesions, SLAP tears, and other specific conditions.

A simple procedure may take less than an hour. Extensive or combined repairs may take several hours.

It is often an outpatient procedure, allowing the patient to return home the same day. Some cases require longer observation.

Recovery may take several weeks to six months or longer. Large repairs and a return to demanding sports may require 6 to 12 months.

It depends on the procedure. A sling may be needed for only a few days after a simple operation or for four to six weeks or longer after a repair.

It is essential in most cases. Physical therapy helps restore movement and strength while protecting the healing tissues.

It depends on the procedure and the type of work. Office duties can usually be resumed sooner than physical or overhead work.

No procedure can guarantee complete pain relief. Results depend on the diagnosis, the injury, tissue quality, surgical technique, and rehabilitation.

Seek immediate care after an injury if you have a deformity, severe pain, loss of movement, numbness, or a cold, pale, or blue hand.