I’m a little worried about the upcoming arthroscopic surgery our 11-year-old is going to have for a shoulder injury that causes his shoulder to pop in and out of joint. Any surgery would worry me but poking tubes into the shoulder of a growing child just gives me the willies. How safe is this procedure anyway?



Surgeons recognize that the use of shoulder arthroscopy in the pediatric population is a valuable tool that must be used carefully and judiciously. In all aspects of treatment (evaluation, preoperative and postoperative care, and the surgery itself), this age group is treated individually and not automatically regarded as adults in small bodies.

This is an important concept as more and more children are developing sports-related shoulder injuries previously only seen in the adult population. Children and adolescents are not “mini-adults” and must be treated with special consideration when performing arthroscopy on the shoulder.

As for surgical techniques, surgeons select the size of arthroscope they use based on the procedure, age of the child, and individual anatomy of each child. Placement is individualized for each pediatric patient since anatomy varies from child to child. Surgeons know that the basic arthroscopic skills learned during training may not always apply to this age group.

When scopes are placed through the anterior (front) of the shoulder, soft tissue structures must be released in a particular order in order in order to preserve and protect them. The surgeon will be careful to avoid damaging the physis (growth plate) or joint in any child or teen who has not completed skeletal growth yet.

There are many advantages of arthroscopic surgery. Arthroscopic examination gives the surgeon the opportunity to carefully and thoroughly examine the shoulder. As a result, damage or injury to the shoulder structures that might have gone undetected is identified and treated.

With smaller incisions possible, there is less pain and stiffness following arthroscopic procedures (compared with open incision surgeries). And studies show that with arthroscopic stabilization of a chronically dislocating shoulder, there are fewer recurrences of dislocation after arthroscopic surgery compared with nonsurgical treatment.