Comprehensive arthroscopic management of the shoulder (CAM)

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What is comprehensive arthroscopic management (CAM)?

Comprehensive arthroscopic management (CAM) is a minimally invasive surgical procedure that is predominantly used for younger patients, often athletes, who have advanced arthritis of the shoulder but who are too young for shoulder joint replacement surgery.

The technique is designed to preserve the joint and delay the need for joint replacement. It alleviates pain along the back and side of the shoulder.

What does comprehensive arthroscopic management involve?

Comprehensive arthroscopic management aims to remove loose cartilage and damaged tissue surrounding the arthritic shoulder joint. Scarred ligaments and tissues around the articular capsule of the shoulder joint are released to restore mobility. Finally, any bony spurs or scar tissue that may be trapping the axillary nerve are removed to decompress the nerve and alleviate pain.

During the procedure a small incision is made in the joint and an arthroscope (tiny camera) is inserted. Surgical instruments are inserted through a second incision. Arthroscopic surgery results in less trauma to the connective tissue than conventional open surgery, leading to faster recovery times and reduced scarring.

Why might I need comprehensive arthroscopic management?

You may be offered comprehensive arthroscopic management if you are suffering from severe arthritis of the shoulder, particularly if you are too young to have a full joint replacement or if you are involved in active sports and are hindered by the loss of movement in your shoulder. The aim is to preserve the joint and enable it to function fully again.

How long does it take to recover?

Because it uses minimally invasive techniques, recovery times for this procedure are quicker than with full joint replacement surgery. Typically the skin wounds will heal and the surgical pain will improve in two weeks. After this you will receive physiotherapy to help regain the function of the shoulder joint, which can take between 6 to 12 weeks.

What is the long-term impact of comprehensive arthroscopic management?

The CAM procedure provides an innovative and welcome alternative to full joint replacement surgery. It has been shown to:

  • Prevent the need for joint replacement surgery for up to five years
  • Achieve high patient satisfaction rates – nine out of ten even at five years after the procedure

As a relatively new technique, long-term outcomes remain unknown but initial results are promising.