The shoulder is a “ball-and-socket” joint made up of the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle). This joint is the most flexible one in the body and allows for a full range of motion, but also makes the shoulder a common source of injury and instability.
Some of the most common shoulder conditions include:
- Rotator cuff tear
While many of these conditions can be effectively managed through nonsurgical techniques, surgery is often needed to thoroughly correct the condition and allow patients to maintain an active and healthy life .
Rotator Cuff Repair
The rotator cuff is a group of tendons and muscles that support the shoulder joint and allow for complete movement while keeping the ball of the arm bone in the shoulder socket. These tendons and muscles may become torn or otherwise damaged from injury or overuse and can lead to pain, weakness and inflammation. Surgery is often needed to treat this serious condition.
Rotator cuff surgery may be performed laparoscopically or through an open procedure, depending on the type and severity of the condition. Both procedures are performed under general anesthesia and aim to reattach the tendon back to the arm, along with removing any loose fragments from the shoulder area.
Labral Tear Surgery
A labrum is a protective cuff of cartilage found in the shoulder that provides stability, cushioning and a full range of motion. A tear in the labrum, known as a labral tear, is caused by injury or overuse and can lead to pain and “catching” of the joint while moving. While many labral tears can be treated by managing pain symptoms and undergoing physical therapy, some cases require surgical treatment.
Labral repair aims to repair unstable shoulders with staples, anchors or sutures. It is usually performed using arthroscopy, which allows the surgeon to view the tear through a small camera and perform the procedure through tiny incisions. Larger tears may require an open procedure.
The shoulder can often become dislocated or slip partially out of the joint, a condition known as subluxation. This often develops as a result of a traumatic injury that may stretch or tear ligaments in the shoulder, and may cause it to become unstable. Patients with an unstable shoulder often avoid participating in sports or other activities they would otherwise enjoy.
Shoulder stabilization can be performed through an arthroscopic procedure that may involve reattaching loose or torn ligaments to the joint with the use of special implants called suture anchors. These anchors are used to relocate and tighten injured structures, and then disintegrate over time. Depending on the individual patient’s joint stability, shoulder stabilization surgery can also repair tears of the biceps muscle tendon, a damaged rotator cuff, or tighten the shoulder capsule.
Arthroscopy is a minimally invasive procedure that can be used to treat many shoulder conditions by inserting a fiber-optic device and tiny surgical instruments into small incisions. Patients can benefit from less tissue damage, shorter recovery times and less scarring with arthroscopic techniques. This procedure can also be used for diagnostic purposes after a physical examination and other imaging procedures have been performed.
Also known as shoulder scope, arthroscopy can be used to treat rotator cuff tears, labral tears, impingement, biceps tendonitis and AC joint arthritis. The type of repair performed depends on each patient’s individual condition, but often involves removing inflamed tissue, reattaching torn tissue or replacing damaged cartilage. The incisions are closed with sutures and usually heal well.
Total Shoulder Replacement
Severe shoulder conditions with persistent symptoms that have not responded to conservative treatments may benefit from shoulder replacement surgery. Shoulder replacement surgery replaces the damaged joint with an artificial one that allows patients to enjoy painless motion and resume their regular activities.
Shoulder replacement surgery is often performed to treat conditions such as:
- Rheumatoid arthritis
- Rotator cuff tears
Patients with severe cases of these conditions often experience pain, limited range of motion, stiffness, swelling and more. These symptoms can be effectively relieved by replacing the damaged bone and cartilage with a metal and plastic implant. Similar to the hip, the shoulder is a ball-and-socket joint that can be significantly improved with joint replacement surgery.
Shoulder replacement surgery takes about two hours to perform and is usually done under general anesthesia. It may be performed arthroscopically or through a traditional open procedure that requires a four to six inch incision.
Patients will be required to stay in the hospital for one to three days and will need physical therapy in order to restore function to the joint after surgery. Most patients are able to return to all of their regular activities after two to three months.
While shoulder replacement surgery has been performed successfully for many years, there are certain risks involved with any surgical procedure. Some of these risks may include infection, blood clots, nerve injury, instability and loosening of the implant. These risks are considered rare, and most patients experience symptom relief and improved range of motion after this procedure.
Reverse Total Shoulder Replacement
Reverse total shoulder replacement is a surgical intervention that aims to repair a condition known as rotator cuff tear arthropathy. This is different than total shoulder replacement because it switches the formation of the glenoid-humeral joint. Naturally, the “ball” of the joint exists as the terminal end of the humerus, but after this procedure the glenoid will be changed into a spherical object that the humerus head can articulate around. This allows the deltoid muscle to lift the arm instead of the torn rotator cuff.
Although this is a very effective method for relieving pain at the shoulder joint, it is normally the last option considered. It is still an invasive surgery that resurfaces the bones, which can be very risky, especially in patients most likely to require this surgery. The bones of elderly individuals are continually weakening as they age, so it is important for doctors to take this into account when determining if the surgery is worthwhile. Additionally, the patient may no longer be able to lift their arm more than a 90 degree angle after this procedure.
For more information, call Southwest Orthopaedic Surgery Specialists in Tucson, AZ at (520) 327-9677. For your convenience, you may Request an Appointment through our web site.