Shoulder Arthroscopy Treatment Cost in India

In a shoulder arthroscopy surgery, the surgeon inserts a small camera which is an arthroscope inside the shoulder joint of the patient. This camera can display images on a screen that the surgeon uses to help him guide through very small surgical instruments inside the shoulder.

Because the size of the arthroscopy or the related instruments is very small, the surgeon can eliminate large incisions which are a

requirement for open types of surgery. This ensures that the patient is suffering less pain and that the recovery time for arthroscopy shoulder surgery is also significantly reduced.

The shoulder is made of bones namely humerus (the upper arm bone), Clavicle (the collar bone) and scapula (the shoulder blade).  The head of the humerus fits into a round socket in the scapula and this socket is referred to as glenoid. To keep the arm centered in the socket, a combination of muscles and tendons work together. These sets of tissues are called the rotator cuff.

Most of the problems can be grouped in the 4 categories:

• Inflammation or tear of a tendon (bursitis or tendinitis)
• Arthritis which is wear and tear
• Instability caused due to sudden injury or overuse or a fractured bone
• Tumors or infection
• Nerve related problems

Various Symptoms may include:

• Excessive pain accompanied by swelling in the shoulder joint
• Redness in the joint on the skin
• Limited movement or not managing any movement
• Deformity and tenderness in the region

A shoulder arthroscopy surgeon may require conducting some series of tests to analyze whether a surgery is required or not.

• X-Rays: injuries to the bones can be seen with the help of this test.
• MRI- Magnetic Resonance Imaging and Ultrasound will reveal the condition of soft tissues in the joint.  MRI can aid the surgeon to identify the tendons and ligaments surrounding the shoulder joint.
• CT scan (Computed Tomography): This is basically X-Rays combined with computer assistance to produce images of the shoulder in detail
• Electrical studies can be used to analyze the condition of the nerves in the region
• Arthrogram: Where a dye is injected into the region to demarcate the shoulder tendons and muscles properly.
• Arthroscopy: with the help of a fiber-optic camera, the surgeon gets to view the detailed condition of the shoulder.

The patient is kept in an operating room and positioned as per the convenience of the surgeon to insert the arthroscope to get a clear view of the damaged shoulder. The two positions in which arthroscopic shoulder replacement surgery takes place are:

• Beach chair position: In this posture, the patient is made to recline in a semi-seated way.
• Lateral decubitus position: on an operating table the patient is made to lie on his or her side.

Both the positions have their own sets of unique advantages and the surgeon selects the most appropriate one depending on the surgery.

The hair from the region of that shoulder will be removed and an antiseptic may be used to wash and cleanse the area. This region will be further covered with sterile drapes and the forearms will be kept in a holding device to ensure that the arm stays in one position all the while.

In order to inflate the joint, some fluid will be injected and this will further enable the surgeon to see the shoulder structures via the instrument arthroscope. For the insertion of the arthroscope, the surgeon will make a very small puncture. Through the arthroscope, fluid is made to flow to keep the view clear and also prevent any bleeding. Damages and the inside of the shoulder images will be displayed on the screen before the surgeon to understand the next course of action.

Beginning from the top and front of the shoulder the surgeon will make a 6 inches long incision on the shoulder which shall further curve along with the deltoid muscle. The surgeon will further cut deep tissues including the rotator cuff tendons in order to penetrate till the shoulder joint.

The humeral head which is the topmost portion of the upper arm bone is gradually dislocated from the scapula’s socket or the glenoid. The area below the rounded humeral head is the humeral neck, which will now be observed by the surgeon. So as a result of arthritis some bone spurs may have developed on the humeral neck which will now be removed by the surgeon using a device called an osteotome.

With the help of a bone saw, the humeral head is removed by the surgeon. Next, the surgeon will prepare the humerus bone for the prosthetic humeral stem. This new graft or the humeral stem is narrow in shape and basically a tapering metal shaft that fits inside the humerus by several inches below. The shaft’s top is so designed so that it can house a prosthetic ball which can further replace the natural humeral head of the shoulder joint.

The surgeon prepares the shoulder socket to receive the new prosthesis by shaping and smoothing the surface with a reamer tool.

This artificial socket is made of polyethylene and the surface is a bit concave in design and smooth to aid in the movement with the prosthetic humeral head.  A flat and straight-edged peg called a keel which is shaped like the keel of a boat is used to back the new socket. This keel is now made to fit the natural bone.

With the help of bone cement, the prosthetics will be made to fit the natural bone. In some cases, the arrangement can be less cement too. This bone cement does not take more than 10 minutes to set.

Before surgery, as a patient please find out the surgeon’s opinion on the health condition of the patient. For a healthy patient who does not have any other severe health problems, the surgery will most likely be performed on an outpatient basis.

Arthroscopic shoulder surgery usually has less time involved in recovery in comparison to conventional ones. Depending on how complicated it was, the patient may be advised to use a slip or an immobilizer for the shoulder for some days and some physical therapy may be advised.

In order to manage the pain, opioids may be prescribed by the doctor and patients must only use those and nothing else.  Any swelling or excessive pain than usual should be immediately reported to the doctor and the incision region should be kept dry and clean.

In a few weeks, the patient can gradually get back to normal life.

The next-generation regenerative injection treatments are slowly gaining prominence.  The stem cell injection or the blood platelet regeneration techniques are now being considered for major arthritis or shoulder replacement requirements.

Apart from these, if the condition is not too severe then the surgeon may also consider ample rest or physiotherapy to improve the condition of the patient before surgery.

Arthroscopic shoulder surgery cost in India is much lower compared to the USA and ranges between $2800 to $4000 depending upon the extent of the injury which is less than even half the cost that may be incurred in the USA with similar amenities and quality of treatment.