What Is the Anatomy of Shoulder Joint?
It is a ball-and-socket joint in the shoulder area. The ball is the upper arm bone's head, while the socket is the shoulder blade's scapula. Numerous ligament and muscle attachments hold the scapula and arm to the body. The acromioclavicular joint joins the front of the scapula (acromion) to the clavicle (collarbone). To keep the ball and socket in its proper alignment as one moves the arm around the body, the scapula of the arm must likewise move.
What Is Scapulothoracic Surgery?
A minimally invasive surgical procedure known as scapulothoracic arthroscopy treats shoulder issues such as snapping scapula syndrome, bursitis and loose bodies, and benign tumors when more conservative treatments have not worked. An arthroscope, a little flexible tube with illumination and a tiny camera at its end, and thin surgical instruments are inserted into the scapulothoracic joint during the surgery to assess and treat the disease.
What Are the Indications for Scapulothoracic Surgery?
Scapulothoracic bursitis, sometimes called snapping scapula syndrome, is the shoulder ailment most frequently associated with the need for scapulothoracic arthroscopy. The scapulothoracic bursa, a closed, fluid-filled sac that rests between the scapula and the chest wall, is characterized by inflammation in the condition. Trauma or repetitive usage from job or athletic endeavors are the causes of the inflammation. The scapulothoracic bursa contributes significantly to the shoulder joint by allowing the shoulder blade to travel painlessly along the chest wall as the arm moves.
Scapulothoracic bursitis causes the following symptoms:
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An ongoing stiffness, soreness, or soreness in the shoulder region.
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A sense of heaviness or instability.
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A cracking or grinding sensation while moving the arm.
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Increased discomfort while engaging in overhead tasks.
Scapulothoracic arthroscopy may be suggested by the doctor if:
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Scapulothoracic bursitis led to a bursectomy (removal of the bursa).
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Removal of loose bodies (debris that floats around in the joint).
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Osteochondroma (benign tumor) removal.
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Due to snapping scapula syndrome, a burectomy and partial superomedial scapulectomy are performed.
What Are the Preparations Done Before Undergoing Scapulothoracic Surgery?
The following procedures are performed before scapulothoracic arthroscopy:
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The physician does a comprehensive examination to determine whether any medical conditions require attention before surgery.
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Depending on the medical history, social background, and age, one might need to go through tests like blood testing and imaging to help detect any anomalies that could jeopardize the procedure's safety.
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Any drugs, vitamins, or supplements the person is taking, and any medical issues like heart or lung illness should be disclosed to a physician.
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Patients could be instructed to abstain from taking blood thinners, anti-inflammatories, multivitamins, or herbal supplements for a week or two.
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Inform the team if one has any latex, drug, or anesthetic sensitivities.
How Is Scapulothoracic Surgery Performed?
The following steps will often be included in the scapulothoracic arthroscopy procedure:
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The anesthesiologist will give either local or general anesthesia.
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If needed, the surgical site will be cleansed and marked with a sterile pen as one lays face down on the operating table.
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The arm is moved into a "chicken wing" posture to improve arthroscopy visibility, which widens the space between the shoulder blade and the posterior chest wall.
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Along the scapula, the doctor makes 2 to 3 tiny keyhole incisions.
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One of the incisions into the scapula is used to implant an arthroscope, a thin, tubular instrument with a light and a tiny camera at its end.
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The doctor can see an image of the interior of the scapulothoracic joint on a monitor.
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The necessary repair, such as the elimination of inflamed bursal tissue, bony protrusions, tumors, or loose bodies, as well as the release of any existent adhesions, is subsequently carried out by the doctor using tiny surgical instruments.
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The doctor removes the scope and the equipment once the scapulothoracic repair is adequate.
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After that, tiny sterile bandage strips or stitches are used to close the tiny incisions.
Postoperative Care and Recovery:
Following a scapulothoracic arthroscopy, recuperation after postoperative care instructions often entails the following steps:
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A nurse will closely monitor the vital signs. At the same time, the person recovers and keeps an eye out for any allergic or anesthetic reactions as the patient is moved to the recovery area.
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The arm shall be immobilized in a shoulder sling which can even be purchased online and worn for two to four weeks after surgery to rest the shoulder and encourage healing.
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Patients might experience some shoulder-related discomfort, soreness, and edema. To treat them, painkillers and anti-inflammatory drugs are given as needed.
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Using cold packs on the shoulder area might also assist in lessening pain and swelling.
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To reduce the risk of infection following surgery, antibiotics are recommended.
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Dry off and keep the surgery site clean. There will be instructions on bathing and caring for the surgical site.
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Avoid smoking because it can slow down the healing process.
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Refraining from driving, hard lifting, and intense activity for the first six weeks. It is advised to raise the activity level gradually.
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The shoulder muscles will be strengthened as part of an individualized physical therapy program, improving shoulder function.
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One can return to regular activities in a few months, but it can take 4 to 6 months to return to the sport.
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A follow-up visit will be made periodically to keep track of the development.
What Are the Risks and Complications of Scapulothoracic Surgery?
Although scapulothoracic arthroscopy is generally risk-free, the following risks and consequences can happen.
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Infection with bleeding.
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Damage to blood vessels or nerves.
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Clots of blood.
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Reaction to anesthetics or allergies.
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Inadequate bursectomy or excision of the bone.
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The requirement for a second surgery.
Conclusion:
For individuals with scapulothoracic syndrome who have not responded to nonoperative therapy options, arthroscopic scapulothoracic treatment offers effective pain reduction and functional improvement.
