Recently, attention has been paid to arthroscopic examination and arthroscopic surgery for shoulder disorders. We have carried out arthroscopic examination of the shoulder since 1981 and performed arthroscopic surgery on fourteen shoulders since 1986. They are seven shoulders in five cases of rheumatoid arthritis (RA), five shoulders in four cases of rupture of rotator cuff (RRC), and two shoulders in one case of labrum tear.
Surgery was performed on all cases with patient under general anesthesia. Arthroscopic examination was performed prior to arthroscopic surgery through both the anterior and posterior approaches with the addition of subacromial approach when necessary. After the findings of the disorders were well known, arthroscopic surgery was performed.
Cases of RA and RRC were elderly people with severe pain of the shoulder joint. Pain in these cases was decreased by intracapsular anesthesia with findings in arthrography showing synovitis. Joint lavage, synovectomy and joint débridement were performed under arthroscopy. Severe pain was relieved in all cases except one case with subacromial bursitis of RA.
The case with labrum tear had locking phenomenon and intracapsular pain. In this case, the injured labrum was partially resected so as not to injure the glenohumeral ligament. After surgery, all complaints in this case disappeared.
