There Are Many Reasons to Rethink Arthroscopy Shoulder Surgery

by Chris Centeno, MD /

arthroscopy shoulder surgery

Arthroscopy shoulder surgery is a common way shoulder injuries are treated. However, since there are significant side effects, do you really need this surgery? These days, precise injections of your own platelets or stem cells are likely to be able to help without surgery. So let's review. 

What Is Arthroscopy Shoulder Surgery?

Arthroscopy shoulder surgery is pushed as a less invasive alternative to open shoulder surgery. The approach to the surgery involves creating anywhere from two to four incisions with portals leading to the damaged shoulder structure. Through one portal, the arthroscope (an instrument with a camera on the end that is linked to a video screen so the surgeon can visualize the surgical site) is passed through to the site. The other portals are used for whatever surgical instruments are necessary to accomplish a specific procedure.

Let’s take a look at some types of arthroscopy shoulder surgery and the reasons they might be performed.

Shoulder Decompression Surgery

With shoulder impingement, shoulder decompression surgery (aka acromioplasty) is a common surgical solution. The idea is that bone spurs can form, causing impingement of the rotator cuff, and the bone spurs must be cut off and the ligaments or acromioclavicular (AC) joint cut away to release the pressure on the rotator cuff. This surface idea, however, doesn’t take into account that those ligaments and the AC joint are major shoulder stabilizers, and typically the bone spurs form to protect the joint from instability.

When the structures that stabilize the shoulder are cut away during decompression surgery, understandably, this creates another problem: shoulder instability. So while the impingement may be addressed, over time, more trauma is experienced by the shoulder as a result of the decompression surgery. Learn more about this surgery in my short video below.

Labrum Repair or Biceps Tenodesis

Arthroscopy shoulder surgery is often recommended for shoulder labrum tears. The labrum is a protective lip positioned around the socket part of the shoulder joint. Depending on the type of labrum tear, a surgeon may perform a labrum repair or a biceps tenodesis. In the former, the torn part of the labrum is removed or stitched back together. In the latter, the biceps tendon is detached from the shoulder socket and reattached at the humerus (the upper arm bone). The problem with these surgeries is that retearing of the labrum is unavoidable as the cause of the tear in the first place—typically hidden shoulder instability—is rarely discovered or addressed. If hidden shoulder instability isn’t addressed, more tears are inevitable. Like many orthopedic surgeries, this is another one I label a surgery that is damage to accomplish a goal.

For a visual of hidden shoulder instability and labrum tears, take a look at the GIF below:

https://regenexx.com/wp-content/uploads/2019/01/ezgif.com-video-to-gif-1.gif

In addition, labrum surgery is riddled with side effects, such as, for starters, infections, failure, chronic pain, loss of biceps strength, and in the case of the biceps tenodesis, even cosmetic deformity of the biceps.

Rotator Cuff Repair

The rotator cuff is the complex of muscles and tendons that support the shoulder. When a rotator cuff tear is found in MRI, a rotator cuff surgery involves stitching the tear back together, is often recommended. On an MRI report, these tears would be classified by degree: partial (involving only part of the tendon) or full-thickness (the tendon is torn completely through). Further if the tear is full-thickness, terminology will include either retracted (snapped back, like a rubber band) or nonretracted (not snapped back). To learn more about your shoulder and reading your own MRI shoulder report, watch my video below:

Like any other arthroscopy shoulder surgery, the lack of effective outcomes of rotator cuff repair are also concerning. Below I have listed a handful:

Avoiding Shoulder Surgery

These days, about 7 in 10 patients who are told they need arthroscopy shoulder surgery can avoid these procedures. How? Precise X-ray- or ultrasound-guided injections of your own platelets or stem cells can help with healing or reduce pain and increase function. However, these are difficult procedures to perform correctly, so you need a physician super-specialist who is often not an orthopedic surgeon to perform these procedures. Specifically, they can not be performed at a high level by a nurse or physician assistant in a chiropractic office. To see what one of these procedures looks like, see my video below:

The upshot? Arthroscopy shoulder surgery can often be avoided, which is a good thing considering the side effects and the lack of evidence that we have that these invasive procedures are effective. So take some time to dive deep into your research on this procedure before pulling the trigger on surgery. 

Category: Uncategorized

Leave a Reply

Your email address will not be published. Required fields are marked *

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.