Shoulder is the most flexible joint in your body. It allows you to place and rotate your arm in many positions in front, above, to the side, and behind your body. This flexibility also makes your shoulder susceptible to instability and injury.
Depending on the nature of the problem, nonsurgical methods of treatment often are recommended before surgery. However, in some instances, delaying the surgical repair of a shoulder can increase the likelihood that the problem will be more difficult to treat later. Early, correct diagnosis and treatment of shoulder problems can make a significant difference in the long run.
Bursitis or Tendinitis : Bursitis and tendinitis are conditions that are also known as soft tissue rheumatic syndromes. A syndrome is a group of signs and symptoms that occur together and indicate a particular problem. This type of syndrome produces pain, swelling, or inflammation in the tissues and structures around a joint, such as the tendons, ligaments, bursae, and muscles.
Impingement and Partial Rotator Cuff Tears : Partial thickness rotator cuff tears can be associated with chronic inflammation and the development of spurs on the underside of the acromion or the acromioclavicular joint. The conservative nonsurgical treatment is modification of activity, light exercise, and, occasionally, a cortisone injection. Nonsurgical treatment is successful in a majority of cases. If it is not successful, surgery often is needed to remove the spurs on the underside of the acromion and to repair the rotator cuff.
Full-Thickness Rotator Cuff Tears : Full thickness Rotator Cuff tears off generally when there is a heavy lifting or a fall. When non-operative treatment like exercise and modification of activities do not work, surgery is required for the full repair. Spurs are removed by arthroscopic technique and repair of the tears in the rotator cuff is done along with it.
Bursitis or Tendinitis :Instability : Shoulder instability is a problem that occurs when the structures that surround the shoulder joint do not work to keep the ball tightly within its socket. If the joint is too loose, it may slide partially out of place, a condition called shoulder subluxation. If the joint comes completely out of place, this is called a shoulder dislocation. Patients with shoulder instability often complain of an uncomfortable sensation that their shoulder may be about to shift out of place.
Fractured Collarbone and Acromioclavicular Joint Separation : A fractured collarbone and acromioclavicular separation are common injuries of children and others who fall on the side of their shoulder when playing. Most of these injuries are treated nonsurgically with slings or splints. Severe displaced fractures or acromioclavicular joint separation may require surgical repair.
Fractured Head of the Humerus (Arm Bone), or Proximal Humerus Fracture :Fractured Head of the Arm Bone occurs particularly to old people with osteoporosis as a result of falling on outstretched arms. Surgical repair is often needed when it is fractured or displaced. Often replacement with an artificial joint or prosthesis is required.
Osteoarthritis and Rheumatoid Arthritis : Osteoarthritis and rheumatoid arthritis can destroy the shoulder joint and surrounding tissue. They can also cause degeneration and tearing of the capsule or the rotator cuff. Osteoarthritis occurs when the articular surface of the joint wears thin. Rheumatoid arthritis is associated with chronic inflammation of the synovium lining which can produce chemicals that eventually destroy the inner lining of the joint, including the articular surface.
The surgeon will conduct a physical examination and may order X-rays, CT Scans or even an MRI to determine the exact cause of the problem. It may be necessary to perform a shoulder Arthroscopy to ascertain the extent of damage or to locate the problem.
Initial treatment may be a course of physiotherapy or cortisone injections to promote natural healing. The surgeon may suggest that the arm is immobilized in a sling so as to allow the damaged tendons and ligaments to heal. If the damage is considered too bad or the above methods fail to improve the condition then surgery may be considered.
Shoulder Surgery can be Used for a Number of Treatments :
Arthroscopic Acromioplasty : This is an arthroscopic procedure to widen the space between the upper arm and the shoulder blade so that the rotator cuff tendons do not get stuck between them. Arthroscopy with shoulder instability – In case of dislocation of the shoulder, it is normal to have an arthroscopy. It is often possible to repair damage to the shoulder but sometimes a separate operation is needed.
Rotator Cuff Repair : Arthroscopic repair of the shoulder tendons. The goal of these procedures is to minimize the pain, restore strength and functionality.
Total Shoulder Replacement : Shoulder arthroplasty – With loss of cartilage the patient will suffer severe shoulder arthritis. This will eventually make surgical treatment is necessary.
The procedure and technique used in shoulder surgery varies depending on the specific surgery. Shoulder surgery is generally performed using one of the following approaches:
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