Shoulder Arthroscopy Vs. Open Surgery: Which Is Better?
Looking For Answers
To the patient who has a shoulder problem like injury to the rotator cuff, bone spurs, or ligament damage, the important thing is not as much how it’s treated but that pain and discomfort go away as quickly and easily as possible. But even a quick glance at the treatment options reveals that issues in this part of the body aren’t that easy to resolve. Typically, surgery is required, so the real question for both doctor and patient is: What kind will work best?
It turns out that surgery for shoulder problems can be separated into two types: open and arthroscopic. The former refers to the more traditional approach, where the area is accessed via an incision—usually about 5 cm—and the necessary work is done. In contrast, arthroscopic surgery involves the use of more specialized instruments. These require smaller incisions—usually only about 5mm each—and rely on the use of a specialized camera that can access the region and allow doctors to see what they’re working on.
Arthroscopic surgery is a more recently developed approach, but does that mean it’s better? It’s worth comparing these two to see what they can and can’t do.
A Smaller Incision: A Bigger Impact
As much as possible, the goal of any surgery is to ensure that it’s as minimally-invasive and well-tolerated as possible. It stands to reason, then, that the arthroscopic approach would be particularly advantageous in this regard; recovering from a couple tiny incisions—versus the procedures necessary to open and then close up the shoulder—is going to be quicker and easier. The fact that you usually go home the same day arthroscopy is done alone should be very convincing.
But of course, the medical and scientific community has also looked into this approach versus more traditional ones. Largely, they concur. For instance, one study from 2005 compared arthroscopic and open surgeries for rotator cuff injury and concluded that “Arthroscopic cuff repair yielded equal or better results than open repair… Patients with an arthroscopic repair had a significantly better decrease in pain and a better functional result concerning mobility.”  A number of follow-up studies came to the same conclusion.
When Open Surgery Is Necessary
Open surgeries typically require a one to two night stay in the hospital. The size and scope of the incision, in addition to the work done on the shoulder, make recovery significantly longer. As Dr. Buess and his team noted, it simply takes more time to regain strength and mobility after this type of treatment. Given the reduced impact of arthroscopic surgery in comparison, why would open surgery even be an option?
It turns out there are a couple reasons. As you might imagine, the ability to work with precision is absolutely essential for a successful surgeon. The slightest mis-step on the operating table can lead to complications or worse damage. For many doctors, then, the increased space that an open surgery allows is what they need for a successful result. Not only that, the severity and location of the actual problem might make arthroscopy a less effective. 
Trusting The Team
At the end of the day, medical care is a team effort. Everyone is involved: the doctors and specialists, the nurses and aides providing support, and the patient him or herself. And what’s most important for the latter is that they find a doctor they can really trust. This means someone who is not only specialized in treating orthopedic cases like shoulder problems, but who is well-versed in the latest advances in the field. Beyond that, though, the right surgeon should be one willing to go over treatments and options with patients. It’s a choice not to be taken lightly.
But the good news is that whether you’re experiencing an impinged shoulder, rotator cuff injury, bone spurs, or something else, dedicated and effective treatments are available. Largely, they’re already very successful, and as newer techniques like arthroscopic surgery become further refined, it’s a safe bet that this trend will continue. It’s not worth living with pain and suffering; if you have shoulder problems, you owe it to yourself to get the care you need as soon as possible.
The team at Onward Orthopedics specializes in a wide range of minimally-invasive treatments and surgeries for shoulder problems. Employing the latest in techniques and technologies, they’ve helped countless patients see true relief and recovery. Learn more about what they do by calling (800) 577-1693 today!
- Buess E, et al. 2005. “Open Versus Arthroscopic Rotator Cuff Repair: A Comparative View Of 96 Cases. – Pubmed – NCBI “. Nlm.Nih.Gov. Accessed January 29 2018. https://www.ncbi.nlm.nih.gov/pubmed/15891728.
Ojedapo Ojeyemi, MD. 2018. “Shoulder Decompression Surgery: Recovery, Risks, And Complications”. Sports-Health. Accessed January 29 2018. https://www.sports-health.com/treatment/shoulder-injury-