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Shoulder Arthroscopy

What shoulder arthroscopy is, what it's used for, and how to prepare and recover.

Overview

Shoulder arthroscopy is a commonly performed procedure with generally low risks, though the literature remains controversial with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines exist pending higher levels of evidence [1]. While morbidity and mortality are rare events after elective shoulder arthroscopy, complications are not necessarily less prevalent or devastating than those associated with open techniques, differing only in nature [3]. The procedure carries a 1.0% thirty-day complication rate overall [6], with patients aged 60 years or older experiencing a slightly higher rate of 1.6% [14]. Despite these figures, elective shoulder arthroscopy should generally be considered safe [13].

The most common complication following the procedure is return to the operating room, accounting for 29% of all complications [6]. In specific populations, such as active patients aged 40 years and older undergoing arthroscopic shoulder stabilization, outcomes remain favorable with low rates of revision surgery and progression to clinically relevant osteoarthritis at a mean follow-up of 7 years [11]. Revision arthroscopic anterior stabilization can result in satisfactory outcomes in appropriately selected patients who have failed previous capsulolabral repair [22].

Surgeons must recognize mixed neuropathy presenting clinically as an anterior interosseous nerve palsy following shoulder arthroscopy and provide appropriate intervention or referral [7]. Furthermore, a criteria-based testing protocol for return to play is strongly recommended following arthroscopic shoulder stabilization to improve recurrence rates [26].

Anatomy & Pathophysiology

A thorough understanding of anatomic principles is essential for successful arthroscopic shoulder surgery [41], as proper patient positioning and portal selection and placement are equally critical [41]. Surgeons should choose the position that they are most comfortable with in order to perform the anticipated arthroscopic shoulder procedures [51]. Shoulder dynamic anterior stabilization (DAS) is an efficient and well-established glenohumeral stabilization technique [39], with the best indication for shoulder dynamic anterior stabilization (DAS) being anteroinferior shoulder instability with limited anterior bone loss [39]. Arthroscopic repair of combined anterior, posterior, and inferior (270°) labral tears of the glenoid fossa yields acceptable clinical outcomes [24] and restores mechanical stability of the shoulder [24].

Outcomes: About one third of stabilized shoulders experienced at least one redislocation after 8 to 10 years [18]. Anchor Strategy: Successful shoulder stabilization can be achieved with fewer than 3 anchors [40], and a single anchor is usually sufficient for successful shoulder stabilization surgery [40]. Complications: Complications of arthroscopic shoulder surgery are not necessarily less prevalent or devastating than those associated with open techniques [3], and complications of arthroscopic shoulder surgery differ in nature from those associated with open techniques [3]. Postoperative Management: Mild restriction of range of motion after shoulder surgery does not require aggressive input [30].

Athletic Function: A substantial number of athletes do not meet expected goals for operative shoulder function and strength compared with the contralateral shoulder at 6 months postoperatively [42]. A substantial number of athletes do not meet expected goals for operative shoulder strength, particularly in external rotation, compared to the contralateral shoulder at 6 months postoperatively [43], and a substantial number of athletes do not meet expected goals for operative shoulder arc of motion compared to the contralateral shoulder at 6 months postoperatively [43]. Chondrolysis Management: Shoulder arthroplasty provided consistent pain relief in cases of severe glenohumeral chondrolysis following shoulder arthroscopy [47], and return of normal range of motion was less predictable in cases of severe glenohumeral chondrolysis following shoulder arthroscopy treated with shoulder arthroplasty [47]. Shoulder arthroplasty provided consistent pain relief in cases of severe glenohumeral chondrolysis following shoulder arthroscopy [48], and return of normal range of motion was less predictable in cases of severe glenohumeral chondrolysis following shoulder arthroscopy treated with shoulder arthroplasty [48].

Classification

Controversy and Guidelines: Shoulder arthroscopy literature remains controversial with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines for shoulder arthroscopy exist pending higher levels of evidence [1].

Complication Profile: Shoulder arthroscopy is a commonly performed procedure with low risks [2]. Complications of arthroscopic shoulder surgery are not necessarily less prevalent or devastating than those associated with open techniques, though they differ in nature [3]. Shoulder arthroscopy has a 1.0% thirty-day complication rate [6]. The most common complication of shoulder arthroscopy is return to the operating room, accounting for 29% of all complications [6].

Patient Demographics and Outcomes: Up to 43% of patients undergoing shoulder arthroscopy can be classified as obese [9]. Early perioperative complications are uncommon in patients undergoing shoulder arthroscopy despite high rates of obesity [9]. Active patients aged 40 years and older undergoing arthroscopic shoulder stabilization experienced favorable functional outcomes at a mean follow-up of 7 years [11]. Active patients aged 40 years and older undergoing arthroscopic shoulder stabilization had low rates of revision surgery or progression to clinically relevant osteoarthritis [11].

Special Populations: Shoulder arthroscopy in patients after arthroplasty is most frequently used as a diagnostic tool [15]. Shoulder arthroscopy in patients after arthroplasty has utility in treating a number of predetermined pathologies [15]. Shoulder arthroscopy is increasingly used to manage a wide range of pathologies in the pediatric population [21]. Special considerations regarding anatomy, anesthetic technique, equipment, and patient positioning are required for shoulder arthroscopy in children and adolescents [21].

Operative Optimization: The addition of epinephrine (0.33 mg/L) to irrigation fluid significantly improves visual clarity in most common types of therapeutic shoulder arthroscopy [37]. The addition of epinephrine (0.33 mg/L) to irrigation fluid shortens total operation time in therapeutic shoulder arthroscopy [37]. A risk stratification index (RSI) system developed for outpatient shoulder arthroscopic surgery is an effective tool to optimize clinical practice with safety and efficiency [46].

Clinical Presentation

The literature regarding shoulder arthroscopy remains controversial, with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines for shoulder arthroscopy currently exist pending higher levels of evidence [1]. Despite these evidentiary gaps, shoulder arthroscopy is a commonly performed procedure associated with low risks [2]. Complications of arthroscopic shoulder surgery are not necessarily less prevalent or devastating than those associated with open techniques, though they differ in nature [3]. The thirty-day complication rate for shoulder arthroscopy is 1.0% [6]. The most common complication following shoulder arthroscopy is return to the operating room, accounting for 29% of all complications [6].

Patient Demographics and Comorbidities

Up to 43% of patients undergoing shoulder arthroscopy can be classified as obese [9]. Early perioperative complications are uncommon in patients undergoing shoulder arthroscopy, even among those classified as obese [9]. Active patients aged 40 years and older undergoing arthroscopic shoulder stabilization experience favorable functional outcomes at a mean follow-up of 7 years [11]. Active patients aged 40 years and older undergoing arthroscopic shoulder stabilization have low rates of revision surgery or progression to clinically relevant osteoarthritis [11]. A larger number of patients screened positive for depression amongst patients undergoing knee and shoulder arthroscopy than were formally diagnosed [31].

Special Populations

Shoulder arthroscopy in patients after arthroplasty is most frequently used as a diagnostic tool [15]. Shoulder arthroscopy in patients after arthroplasty has utility in treating a number of predetermined pathologies [15]. Shoulder arthroscopy is increasingly used to manage a wide range of pathologies in the pediatric population [21]. Special considerations regarding anatomy, anesthetic technique, equipment, and patient positioning are required for shoulder arthroscopy in children and adolescents [21].

Red-Flag Patterns and Complications

Glenohumeral chondrolysis is a rare and devastating complication of shoulder arthroscopy that can occur rapidly after routine procedures [16]. Chondrolysis is a devastating complication of arthroscopic shoulder surgery that can result in long-term disabling consequences [17]. Pseudoaneurysm should be considered as a diagnosis in postoperative patients with pain and a new-onset mass after shoulder arthroscopy [19]. Fluid extravasation has the potential to be a life-threatening complication of shoulder arthroscopic surgery [20]. Fluid extravasation is most commonly managed nonoperatively [20]. Symptoms of fluid extravasation typically resolve with no evidence of long-term complications [20]. Special attention should be paid to patients with sudden dyspnea after shoulder arthroscopy to avoid misdiagnosis and missed diagnosis [33].

Investigations

Plain radiography: Progressive glenoid radiolucencies may develop in young patients with shoulder chondrolysis following arthroscopic shoulder surgery treated with total shoulder arthroplasty [56]. Diagnostic imaging may not reliably correlate with diagnostic arthroscopic findings at the time of a Latarjet procedure from both a bony and soft-tissue perspective [54].

MRI: Radiologists miss approximately 50% of subscapularis tears on MRI examination prior to shoulder arthroscopy in community practice [52]. Shoulder surgeons miss 28.6% of subscapularis tears on MRI examination prior to shoulder arthroscopy in community practice [52].

CT: The first large cohort study to radiologically assess prospective portal position in shoulder arthroscopy utilized computerized tomography images [55].

Other Considerations: Shoulder arthroscopy literature remains controversial with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines for shoulder arthroscopy exist pending higher levels of evidence [1]. Shoulder arthroscopy is a commonly performed procedure with low risks [2], yet complications are not necessarily less prevalent or devastating than those associated with open techniques, though they differ in nature [3]. Up to 43% of patients undergoing shoulder arthroscopy can be classified as obese [9], yet early perioperative complications in these patients remain uncommon [9].

Glenohumeral chondrolysis is a rare and devastating complication of shoulder arthroscopy that can occur rapidly after routine procedures [16]. Early results of total shoulder arthroplasty for young patients with shoulder chondrolysis show an opportunity for improvements in pain and function [56]. Mixed neuropathy presenting clinically as an anterior interosseous nerve palsy is a complication following shoulder arthroscopy [7]. Surgeons should consider pseudoaneurysm as a possibility in postoperative patients with pain and a new-onset mass after shoulder arthroscopy [19].

Shoulder arthroscopy in the year prior to shoulder arthroplasty is associated with an increased risk of complications, including revision and aseptic loosening [25]. Diagnostic arthroscopy is a helpful tool for evaluating painful anatomic total shoulder arthroplasty by providing information on periprosthetic infection, cuff tears, implant wear, and loosening [59]. Shoulder arthroscopy in patients after arthroplasty is most frequently used as a diagnostic tool [15] and has utility in treating a number of predetermined pathologies [15].

The space between the direct biceps tendon and supraspinatus can be a reliable adjunct for verification of rotator cuff tear during shoulder arthroscopy in the lateral decubitus position [58], but direct biceps tendon and supraspinatus contact should not replace a full arthroscopic evaluation for rotator cuff tear verification [58].

Treatment

Shoulder arthroscopy is a commonly performed procedure with generally low risks, though the literature remains controversial with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines exist pending higher levels of evidence [1]. While elective shoulder arthroscopy should generally be considered safe and morbidity and mortality are rare events [13], complications are not necessarily less prevalent or devastating than those associated with open techniques, though they differ in nature [3]. The overall thirty-day complication rate is 1.0% [6], rising to 1.6% in patients aged 60 years or older, a rate higher than previously reported for the overall population [14]. The most common complication is return to the operating room, accounting for 29% of all complications [6]. Fluid extravasation has the potential to be a life-threatening complication but is most commonly managed nonoperatively, with symptoms typically resolving without long-term sequelae [20].

Indications: Active patients aged 40 years and older undergoing arthroscopic shoulder stabilization experience favorable functional outcomes at a mean follow-up of 7 years [11]. This population also demonstrates low rates of revision surgery or progression to clinically relevant osteoarthritis [11]. Revision arthroscopic anterior stabilization yields satisfactory outcomes in appropriately selected patients who have failed previous capsulolabral repair [22], as does arthroscopic revision stabilization in patients with failed previous capsulabral repair [23]. Arthroscopic repair of combined anterior, posterior, and inferior (270°) labral tears of the glenoid fossa yields acceptable clinical outcomes and restores mechanical stability [24]. Denial of shoulder arthroscopy on the basis of body mass index alone may not be an appropriate strategy for risk reduction [57].

Pain Management: A multimodal nonopioid pain regimen provides equivalent pain control, adverse reaction profiles, and patient satisfaction compared with a standard opioid-based regimen following arthroscopic shoulder labral surgery [53].

Adjuncts: Shoulder arthroscopy should be avoided within 4 weeks of a pre-operative steroid injection unless there is strong justification [36]. A cautious, individualized approach should be used before offering corticosteroid injections to patients anticipated to undergo subsequent shoulder arthroscopy [36].

Other Considerations: A criteria-based testing protocol for return to play is strongly recommended following arthroscopic shoulder stabilization to improve recurrence rates [26]. Mild restriction of range of motion after shoulder surgery does not require aggressive input [30]. Both groups achieved the patient acceptable symptom state after shoulder arthroscopy regardless of suprascapular nerve treatment in elite overhead athletes [32].

Complications

General Safety and Incidence: Shoulder arthroscopy is a commonly performed procedure with low risks [2], and morbidity and mortality are rare events after elective shoulder arthroscopy, generally considered safe [13]. The overall thirty-day complication rate is 1.0% [6], with complication rates typically ranging between 1% and 2% [34]. Readmission rates are less than 1% [34]. While complications are not necessarily less prevalent or devastating than those associated with open techniques, they differ in nature [3]. The most common complication is return to the operating room, accounting for 29% of all complications [6].

Stiffness and Arthrofibrosis: An age between 46 and 60 years is a statistically significant risk factor for frozen shoulder after simple arthroscopic shoulder procedures [27]. A previous history of contralateral frozen shoulder is also a statistically significant risk factor for frozen shoulder after simple arthroscopic shoulder procedures [27].

Instability: About one third of stabilized shoulders experienced at least one redislocation after 8 to 10 years following arthroscopic shoulder stabilization using suture anchors [18].

Infection: The risk of infection following shoulder arthroscopy was 0.21% [28].

Chondrolysis: Glenohumeral chondrolysis is a rare and devastating complication of shoulder arthroscopy that can occur rapidly after routine procedures [16]. Chondrolysis is a devastating complication of arthroscopic shoulder surgery that can result in longterm disabling consequences [17].

Other Considerations: Increasing age is a risk factor for adverse events after shoulder arthroscopy [34], and patients 60 years or older have a low overall 30-day postoperative complication rate of 1.6%, which is higher than previously reported for the overall shoulder arthroscopy population [14]. Higher ASA scores are a risk factor for adverse events after shoulder arthroscopy [34]. Up to 43% of patients undergoing shoulder arthroscopy can be classified as obese, but early perioperative complications are uncommon [9]. Resident involvement in shoulder arthroscopy was not associated with increased risk of adverse events within 30 days, increased operative time, or readmission within 30 days [35]. Shoulder arthroscopy in the year prior to shoulder arthroplasty is associated with an increased risk of complications, including revision and aseptic loosening [25]. Patients who undergo shoulder arthroscopy with a history of anterior cervical discectomy and fusion (ACDF) are twice as likely to undergo revision arthroscopy within 2 years of surgery compared with those without a history of ACDF [29]. These patients are also at an increased risk of complications within 30 days postoperatively and prolonged opioid use compared with those without a history of ACDF [29].

Recovery

Light activity (weeks): Patients may typically resume desk work, driving, and light activities of daily living within the early postoperative period, though specific timelines vary by procedure and patient factors. Elective shoulder arthroscopy is generally considered safe regarding morbidity and mortality, with overall 30-day complication rates reported at 1.0% [6] and 1.6% in patients aged 60 years or older [14]. While early perioperative complications are uncommon even in obese populations, which comprise up to 43% of patients [9], those with a history of anterior cervical discectomy and fusion (ACDF) face a doubled risk of revision within 2 years and increased risks of 30-day complications and prolonged opioid use [29].

Full activity (months): Return to manual work and sport is contingent on functional recovery, with active patients aged 40 years and older undergoing arthroscopic stabilization demonstrating favorable functional outcomes at a mean follow-up of 7 years [11]. Arthroscopic revision stabilization can yield satisfactory outcomes for patients failing previous capsulabral repair [23]. However, surgeons must note that about one third of stabilized shoulders experience at least one redislocation after 8 to 10 years when using suture anchors [18]. Additionally, bone mineral in the calcanei of men decreased more than the expected age-dependent decline during a 5-year study period following surgery [61].

Complete recovery / outcome plateau (months): Final functional outcomes and pain stabilization typically occur by the 7-year mark, where active patients aged 40 years and older show low rates of revision surgery and progression to clinically relevant osteoarthritis [11]. Chondrolysis remains a devastating complication with long-term disabling consequences [17]. Patient compliance with electronic patient-reported outcome measure (PROM) systems decreases over time, with the lowest completion rates observed at the traditional 2-year follow-up [60].

Rehabilitation protocol: Specific phasing details are not explicitly defined in the provided evidence base; however, arthroscopic labral repair utilizing a low anteroinferior portal demonstrates no signs of structural or functional subscapularis impairment after 9.6-year follow-up [50].

Functional milestones: Validated outcomes include the low rates of revision and osteoarthritis progression noted in the 7-year cohort [11]. Risk stratification for functional decline includes an age between 46 and 60 years and a previous history of contralateral frozen shoulder, both of which are statistically significant risk factors for developing frozen shoulder after simple arthroscopic procedures [27].

Other Considerations: The literature regarding shoulder arthroscopy remains controversial with conclusions often unsupported due to bias and limitations [1]. Consequently, no definitive clinical guidelines exist pending higher levels of evidence [1]. While morbidity and mortality are rare events [13], the most common complication is return to the operating room, accounting for 29% of all complications [6]. The risk of infection is 0.21% and is similar to reported numbers from other large series [28].

Key Evidence

  • [L5] The editorial states that shoulder arthroscopy literature remains controversial, conclusions are often unsupported due to bias and limitations, and no clinical guidelines are definitive pending higher levels of evidence. (10.1016/j.arthro.2012.07.001)
  • [L5] Shoulder arthroscopy is a commonly performed procedure with low risks. (10.1016/j.jhsa.2015.01.002)
  • [L4] Complications of arthroscopic shoulder surgery are not necessarily less prevalent or devastating than those associated with open techniques, though they differ in nature. (10.5435/jaaos-22-07-410)
  • [L4] Shoulder arthroscopy has a 1.0% thirty-day complication rate, with the most common complication being return to the operating room (29% of all complications). (10.1016/j.arthro.2014.12.011)
  • [L4] Recognizing this complication and providing appropriate intervention or referral are important for any surgeon performing shoulder arthroscopies. (10.1016/j.jse.2016.04.037)
  • [L3] Up to 43% of patients undergoing shoulder arthroscopy can be classified as obese, but early perioperative complications are uncommon. (10.1016/j.arthro.2016.03.022)
  • [L4] Active patients aged 40 years and older undergoing arthroscopic shoulder stabilization experienced favorable functional outcomes at a mean follow-up of 7 years, with low rates of revision surgery or of progression to clinically relevant osteoarthritis. (10.1016/j.jseint.2024.05.015)
  • [L2] Morbidity and mortality are rare events after elective shoulder arthroscopy, and the procedure should generally be considered safe. (10.1016/j.jse.2013.06.022)
  • [L3] Patients 60 years or older who underwent shoulder arthroscopy have a low overall 30-day postoperative complication rate of 1.6%, which is higher than previously reported for the overall shoulder arthroscopy population. (10.1016/j.arthro.2016.05.035)
  • [L4] Shoulder arthroscopy in patients after arthroplasty is most frequently used as a diagnostic tool; however, it has utility in treating a number of predetermined pathologies. (10.1016/j.jse.2015.09.013)
  • [L4] Glenohumeral chondrolysis is a rare and devastating complication of shoulder arthroscopy that can occur rapidly after routine procedures. (10.1177/0363546503262176)
  • [L4] Chondrolysis is a devastating complication of arthroscopic shoulder surgery that can result in longterm disabling consequences. (10.1016/j.jse.2008.10.017)
  • [L4] With a follow-up of 97%, about one third of the stabilized shoulders experienced at least one redislocation after 8 to 10 years. (10.1177/0363546511415657)
  • [L5] Review of this complication should alert surgeons to consider this diagnosis as a possibility in postoperative patients with pain and a new-onset mass, after shoulder arthroscopy. (10.1016/j.jse.2013.05.018)
  • [L4] Fluid extravasation has the potential to be a life-threatening complication of shoulder arthroscopic surgery; however, it is most commonly managed nonoperatively, and symptoms typically resolve with no evidence of long-term complications. (10.1177/2325967118771616)
  • [L5] Shoulder arthroscopy is increasingly used to manage a wide range of pathologies in the pediatric population, but special considerations regarding anatomy, anesthetic technique, equipment, and patient positioning are required. (10.5435/00124635-201307000-00004)
  • [L4] Revision arthroscopic anterior stabilization of the shoulder can result in satisfactory outcomes in appropriately selected patients who have failed previous capsulolabral repair. (10.1016/j.jse.2014.11.034)
  • [L3] Arthroscopic revision stabilization of the shoulder can result in satisfactory outcomes in patients who have failed previous capsulabral repair. (10.1177/2325967115s00012)
  • [L4] Arthroscopic repair of combined anterior, posterior, and inferior (270°) labral tears of the glenoid fossa yields acceptable clinical outcomes and restores mechanical stability of the shoulder. (10.1016/j.arthro.2012.04.067)
  • [L3] Shoulder arthroscopy in the year prior to shoulder arthroplasty is associated with an increased risk of complications, including revision and aseptic loosening. (10.1177/17585732231176269)
  • [L3] Based on our findings, we strongly recommend the utilization of a criteria based testing protocol for return to play following arthroscopic shoulder stabilization. (10.1177/2325967120s00381)
  • [L3] An age of between 46 and 60 years and a previous history of contralateral frozen shoulder were statistically significant risk factors. (10.1302/0301-620x.97b7.35387)
  • [L3] The risk of infection following shoulder arthroscopy was 0.21%, similar to reported numbers from other large series. (10.1177/2325967117s00362)
  • [L3] Patients who undergo shoulder arthroscopy with a history of ACDF are twice as likely to undergo revision arthroscopy within 2 years of surgery and are at an increased risk of complications within 30 days postoperatively as well as prolonged opioid use compared with those without a history of ACDF. (10.1016/j.arthro.2019.08.037)
  • [L4] Mild restriction of ROM after shoulder surgery does not require aggressive input. (10.1111/j.1758-5740.2012.00184.x)
  • [L3] Overall, a larger number of patients screened positive for depression amongst patients undergoing knee and shoulder arthroscopy than were formally diagnosed. (10.1177/2325967124s00350)
  • [L3] Regardless of SSN treatment, both groups achieved the patient acceptable symptom state after shoulder arthroscopy. (10.1016/j.arthro.2018.03.046)
  • [Case_report] Special attention should be paid to patients with sudden dyspnea after shoulder arthroscopy, and early diagnosis and treatment should be conducted according to the symptoms, signs and imaging examinations of patients to avoid misdiagnosis and missed diagnosis. (10.1186/s12891-025-08502-5)
  • [L3] Complication rates after shoulder arthroscopy are low (between 1% and 2%) and readmission rates are less than 1%, with increasing age and higher ASA scores identified as risk factors for adverse events. (10.1016/j.arthro.2016.11.010)
  • [L3] Resident involvement in shoulder arthroscopy was not associated with increased risk of adverse events, increased operative time, or readmission within 30 days. (10.1177/2325967118816293)
  • [L5] The editorial concludes that shoulder arthroscopy should be avoided within 4 weeks of a pre-operative steroid injection unless there is strong justification, and that a cautious, individualized approach should be used before offering corticosteroid injections to patients anticipated to undergo subsequent shoulder arthroscopy. (10.1016/j.arthro.2023.10.006)
  • [L1] The addition of epinephrine (0.33 mg/L) to irrigation fluid significantly improves visual clarity in most common types of therapeutic shoulder arthroscopy. (10.1016/j.arthro.2015.08.027)
  • [L3] Arthroscopic procedures are safe with very low complication rates. (10.1016/j.arthro.2018.10.108)
  • [L5] Shoulder dynamic anterior stabilization (DAS) is an efficient and well-established glenohumeral stabilization technique, with the best indication being anteroinferior shoulder instability with limited anterior bone loss. (10.1016/j.arthro.2023.02.013)
  • [L3] Successful shoulder stabilization can be achieved with fewer than 3 anchors, and a single anchor is usually sufficient. (10.1016/j.jse.2013.08.010)
  • [L5] A thorough understanding of anatomic principles in conjunction with proper patient positioning and portal selection and placement are essential for successful arthroscopic shoulder surgery. (10.5435/00124635-201306000-00003)
  • [L4] A substantial number of athletes do not meet expected goals for operative shoulder function and strength compared with the contralateral shoulder at 6 months postoperatively. (10.1016/j.jse.2020.04.035)
  • [L3] A substantial number of athletes in our cohort do not meet the expected goals for their operative shoulder in achieving appropriate strength, particularly in ER, nor arc of motion compared to the contralateral shoulder. (10.1177/2325967119s00375)
  • [L3] The authors developed an RSI tool for shoulder arthroscopic surgery using an existing national database and concluded that the RSI system is an effective tool to optimize clinical practice with safety and efficiency. (10.1016/j.jses.2017.03.005)
  • [Abstract] Shoulder arthroplasty provided consistent pain relief but return of normal range of motion was less predictable. (10.1016/j.jse.2007.02.099)
  • [Abstract] Shoulder arthroplasty provided consistent pain relief but return of normal range of motion was less predictable. (10.1016/j.jse.2007.02.015)
  • [L4] Arthroscopic labral repair with a low anteroinferior portal demonstrates no signs of structural and functional impairment of the subscapularis after 9.6-year follow-up. (10.1007/s00167-015-3545-4)
  • [L4] Surgeons should choose the position that they are most comfortable with in order to perform the anticipated arthroscopic shoulder procedures. (10.1016/j.arthro.2008.10.003)
  • [L3] In a community practice, radiologists miss approximately 50% of subscapularis tears on MRI examination, while a shoulder surgeon misses 28.6%. (10.1016/j.asmr.2023.100825)
  • [L1] This study found that a multimodal nonopioid pain regimen provided, at the minimum, equivalent pain control, an equivalent adverse reaction profile, and equivalent patient satisfaction when compared with a standard opioid-based regimen following arthroscopic shoulder labral surgery. (10.1016/j.jse.2021.07.008)
  • [L4] Diagnostic imaging may not reliably correlate with diagnostic arthroscopic findings at the time of a Latarjet procedure from both a bony perspective and a soft-tissue perspective. (10.1016/j.asmr.2021.09.014)
  • [L2] This is the first large cohort study to radiologically assess prospective portal position in shoulder arthroscopy. (10.1016/j.xrrt.2021.04.017)
  • [L4] Early results of total shoulder arthroplasty show an opportunity for improvements in pain and function; however, progressive glenoid radiolucencies may develop in these patients. (10.1016/j.jse.2007.11.004)
  • [L3] Denial of shoulder arthroscopy on the basis of BMI alone may not be an appropriate strategy for risk reduction. (10.1016/j.arthro.2018.10.136)
  • [L3] The space can be a reliable adjunct for verification but should not replace a full arthroscopic evaluation. (10.1016/j.jse.2006.09.005)
  • [L5] Diagnostic arthroscopy is a helpful tool for evaluating painful anatomic total shoulder arthroplasty by providing information on periprosthetic infection, cuff tears, implant wear, and loosening. (10.1016/j.xrrt.2025.06.011)
  • [L4] Patient compliance with PROMs decreased over time with the lowest percentage of patients completing electronic surveys at the traditional 2-year follow-up for shoulder arthroscopy. (10.1016/j.asmr.2022.11.004)
  • [L3] The bone mineral in the calcanei in men during the 5-year study period decreased more than the expected age-dependent decline after arthroscopic shoulder surgery. (10.1007/s00167-015-3760-z)

See Also

References

[1] Shoulder Arthroscopy Literature Remains Controversial. Arthroscopy. 2012. DOI: 10.1016/j.arthro.2012.07.001

[2] Shoulder Arthroscopy: The Basics. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.01.002

[3] Complications of Shoulder Arthroscopy. Journal of the American Academy of Orthopaedic Surgeons. 2014. DOI: 10.5435/jaaos-22-07-410

[6] An Analysis of Adult Patient Risk Factors and Complications Within 30 Days After Arthroscopic Shoulder Surgery. Arthroscopy. 2015. DOI: 10.1016/j.arthro.2014.12.011

[7] Mixed neuropathy presenting clinically as an anterior interosseous nerve palsy following shoulder arthroscopy: a report of four cases. Journal of Shoulder and Elbow Surgery. 2016. DOI: 10.1016/j.jse.2016.04.037

[9] The Effects of Patient Obesity on Early Postoperative Complications After Shoulder Arthroscopy. Arthroscopy. 2016. DOI: 10.1016/j.arthro.2016.03.022

[11] Outcomes of primary arthroscopic shoulder stabilization in active patients over 40—results at a mean follow-up of 7 years. JSES International. 2024. DOI: 10.1016/j.jseint.2024.05.015

[13] 30-day morbidity and mortality after elective shoulder arthroscopy: a review of 9410 cases. Journal of Shoulder and Elbow Surgery. 2013. DOI: 10.1016/j.jse.2013.06.022

[14] Shoulder Arthroscopy in Adults 60 or Older: Risk Factors That Correlate With Postoperative Complications in the First 30 Days. Arthroscopy. 2016. DOI: 10.1016/j.arthro.2016.05.035

[15] Indications and outcomes of shoulder arthroscopy after shoulder arthroplasty. Journal of Shoulder and Elbow Surgery. 2016. DOI: 10.1016/j.jse.2015.09.013

[16] Glenohumeral Chondrolysis after Shoulder Arthroscopy. The American Journal of Sports Medicine. 2004. DOI: 10.1177/0363546503262176

[17] Severe chondrolysis after shoulder arthroscopy: A case series. Journal of Shoulder and Elbow Surgery. 2009. DOI: 10.1016/j.jse.2008.10.017

[18] Long-term Results After Arthroscopic Shoulder Stabilization Using Suture Anchors. The American Journal of Sports Medicine. 2011. DOI: 10.1177/0363546511415657

[19] Pseudoaneurysm after shoulder arthroscopy. Journal of Shoulder and Elbow Surgery. 2013. DOI: 10.1016/j.jse.2013.05.018

[20] Fluid Extravasation in Shoulder Arthroscopic Surgery: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118771616

[21] Shoulder Arthroscopy in Children and Adolescents. Journal of the American Academy of Orthopaedic Surgeons. 2013. DOI: 10.5435/00124635-201307000-00004

[22] Clinical Outcomes Following Revision Shoulder Arthroscopic Capsulolabral Stabilization. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2014.11.034

[23] Clinical Outcomes Following Revision Shoulder Arthroscopic Capsulolabral Stabilization. Orthopaedic Journal of Sports Medicine. 2015. DOI: 10.1177/2325967115s00012

[24] Arthroscopic Shoulder Repair of Combined Anterior, Posterior, and Inferior (270°) Labral Tears: A Retrospective Review (SS‐07). Arthroscopy. 2012. DOI: 10.1016/j.arthro.2012.04.067

[25] Increased revision rates in shoulder arthroplasty following shoulder arthroscopy. Shoulder & Elbow. 2023. DOI: 10.1177/17585732231176269

[26] Recurrence Rates Following Arthroscopic Shoulder Stabilization are Improved Following a Criteria Based Return to Sport Testing Protocol. Orthopaedic Journal of Sports Medicine. 2020. DOI: 10.1177/2325967120s00381

[27] Frozen shoulder after simple arthroscopic shoulder procedures. The Bone & Joint Journal. 2015. DOI: 10.1302/0301-620x.97b7.35387

[28] Patient-Related Risk Factors for Postoperative Infection Following Shoulder Arthroscopy: An Analysis of Over 420,000 Patients. Orthopaedic Journal of Sports Medicine. 2017. DOI: 10.1177/2325967117s00362

[29] Risk of Revision Shoulder Surgery, Complications, and Prolonged Opioid Use in Patients Undergoing Shoulder Arthroscopy Who Have Previously Undergone Anterior Cervical Discectomy and Fusion. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2019.08.037

[30] Stiffness after Arthroscopic Shoulder Surgery: Incidence, Management and Classification. Shoulder & Elbow. 2012. DOI: 10.1111/j.1758-5740.2012.00184.x

[31] Poster 385: Incidence of Preoperative Depression in Knee and Shoulder Arthroscopy Using Patient Health Questionnaire-2 (PHQ-2). Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/2325967124s00350

[32] Shoulder Arthroscopy With Versus Without Suprascapular Nerve Release: Clinical Outcomes and Return to Sport Rate in Elite Overhead Athletes. Arthroscopy. 2018. DOI: 10.1016/j.arthro.2018.03.046

[33] Delayed tension pneumothorax 2 days after shoulder arthroscopic rotator cuff repair: a case report. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08502-5

[34] Shoulder Arthroscopy Complication and Readmission Rates: Impact on Value. Arthroscopy. 2017. DOI: 10.1016/j.arthro.2016.11.010

[35] Resident Involvement in Shoulder Arthroscopy Is Not Associated With Short-term Risk to Patients. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118816293

[36] Editorial Commentary: Corticosteroid Injections Administered Within 4 Weeks Before Shoulder Arthroscopy Are Associated With an Increased Risk of Infection. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2023.10.006

[37] Epinephrine Diluted Saline–Irrigation Fluid in Arthroscopic Shoulder Surgery: A Significant Improvement of Clarity of Visual Field and Shortening of Total Operation Time. A Randomized Controlled Trial. Arthroscopy. 2015. DOI: 10.1016/j.arthro.2015.08.027

[38] Body Mass Index as a Risk Factor for 30‐Day Postoperative Complications in Knee, Hip, and Shoulder Arthroscopy. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2018.10.108

[39] Editorial Commentary: Shoulder Arthroscopic Dynamic Anterior Stabilization Is Effective for Anteroinferior Shoulder Instability With Limited Anterior Bone Loss. Arthroscopy. 2023. DOI: 10.1016/j.arthro.2023.02.013

[40] Fewer anchors achieves successful arthroscopic shoulder stabilization surgery: 114 patients with 4 years of follow-up. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2013.08.010

[41] Shoulder Arthroscopy: Basic Principles of Positioning, Anesthesia, and Portal Anatomy. Journal of the American Academy of Orthopaedic Surgeons. 2013. DOI: 10.5435/00124635-201306000-00003

[42] Return to sport testing at 6 months after arthroscopic shoulder stabilization reveals residual strength and functional deficits. Journal of Shoulder and Elbow Surgery. 2020. DOI: 10.1016/j.jse.2020.04.035

[43] Return To Sport Testing At 6 Months After Arthroscopic Shoulder Stabilization Demonstrates Residual Functional Deficits. Orthopaedic Journal of Sports Medicine. 2019. DOI: 10.1177/2325967119s00375

[46] The development and application of a risk stratification index system for outpatient shoulder arthroscopy patient management—a single academic center's experience. JSES Open Access. 2017. DOI: 10.1016/j.jses.2017.03.005

[47] Severe Glenohumeral Chondrolysis Following Shoulder Arthroscopy: A Series Of 6 Cases Treated With Hemiarthroplasty. Journal of Shoulder and Elbow Surgery. 2007. DOI: 10.1016/j.jse.2007.02.099

[48] Severe Glenohumeral Chondrolysis Following Shoulder Arthroscopy: A Series Of 6 Cases Treated With Hemiarthroplasty. Journal of Shoulder and Elbow Surgery. 2007. DOI: 10.1016/j.jse.2007.02.015

[50] Long-term effects on subscapularis integrity and function following arthroscopic shoulder stabilization with a low anteroinferior (5:30 o’clock) portal. Knee Surgery, Sports Traumatology, Arthroscopy. 2015. DOI: 10.1007/s00167-015-3545-4

[51] Shoulder Arthroscopy Positioning: Lateral Decubitus Versus Beach Chair. Arthroscopy. 2008. DOI: 10.1016/j.arthro.2008.10.003

[52] Both Radiologists and Surgeons Miss a Substantial Number of Subscapularis Tears on Magnetic Resonance Imaging Examination Prior to Shoulder Arthroscopy. Arthroscopy, Sports Medicine, and Rehabilitation. 2023. DOI: 10.1016/j.asmr.2023.100825

[53] Multimodal nonopioid pain protocol provides equivalent pain control versus opioids following arthroscopic shoulder labral surgery: a prospective randomized controlled trial. Journal of Shoulder and Elbow Surgery. 2021. DOI: 10.1016/j.jse.2021.07.008

[54] Shoulder Arthroscopy in Conjunction With an Open Latarjet Procedure Can Identify Pathology That May Not Be Accounted for With Magnetic Resonance Imaging. Arthroscopy, Sports Medicine, and Rehabilitation. 2021. DOI: 10.1016/j.asmr.2021.09.014

[55] Determining the accurate placement of a posterior portal in shoulder arthroscopy with the use of computerized tomography images. JSES Reviews, Reports, and Techniques. 2021. DOI: 10.1016/j.xrrt.2021.04.017

[56] Young patients with shoulder chondrolysis following arthroscopic shoulder surgery treated with total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery. 2008. DOI: 10.1016/j.jse.2007.11.004

[57] The Impact of Body Mass Index on Complications After Shoulder Arthroscopy: Should Surgery Eligibility Be Determined by Body Mass Index Cutoffs?. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2018.10.136

[58] Direct biceps tendon and supraspinatus contact as an indicator of rotator cuff tear during shoulder arthroscopy in the lateral decubitus position. Journal of Shoulder and Elbow Surgery. 2007. DOI: 10.1016/j.jse.2006.09.005

[59] Benefits and limitations of diagnostic shoulder arthroscopy for painful anatomical shoulder arthroplasty investigation. JSES Reviews, Reports, and Techniques. 2025. DOI: 10.1016/j.xrrt.2025.06.011

[60] Compliance with Electronic Patient Reported Outcome Measure System Data Collection Is 51% Two‐years After Shoulder Arthroscopy. Arthroscopy, Sports Medicine, and Rehabilitation. 2022. DOI: 10.1016/j.asmr.2022.11.004

[61] Bone mineral decreases in the calcanei in men after arthroscopic shoulder surgery: a prospective study over 5 years. Knee Surgery, Sports Traumatology, Arthroscopy. 2015. DOI: 10.1007/s00167-015-3760-z

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