Shoulder arthroscopy in 2003

Shoulder arthroscopy is, in 2003, as reliable and efficient as kneearthroscopy. Shoulder arthroscopy is realized under regional anesthesiaassociated with general anesthesia. It requires specific andexpensive equipment. Muscular and neuro-vascular systems surroundingthe joint require very precise portals for optical and instruments.Indications of diagnostic arthroscopy are discussed for athletes havingshoulder pain despite rehabilitation and negative imaging.But operative shoulder arthroscopy is now performed with advantagessuch as: no scar, reduced postoperative pain, reduced risk ofinfection, shorter hospital stay. Many arthroscopic operative procedurescan be done: excision of calcium deposit of the cuff, acromioplastyand tenotomy or tenodesis of long head of biceps.Arthroscopic repair of cuff tears and Bankart repair are more sophisticatedprocedures and have to be performed in specializedshoulder units. Both have limits, depending on the type and size ofthe lesions. Shoulder arthroscopy, which we have practiced for over10 years, is used for more than 50 % of our patients. It requiresspecific training to be done safely by most orthopedic surgeons.