Shoulder Archives - Snibbe Orthopedics

Total Shoulder Arthroplasty

Total shoulder arthroplasty involves removing the damaged cartilage that lines the joint and replacing it with a metal implant. In this procedure, the ball of the shoulder is replaced with a metal ball and the socket of the shoulder is replaced with a metal socket and plastic liner. The implants used are made of titanium or cobalt chrome. They are sometimes cemented in place for additional stability.

Reverse Total Shoulder Arthroplasty

Reverse total shoulder arthroplasty involves removing the damaged cartilage that lines the joint and replacing it with a metal implant. In this procedure, the ball of the shoulder is replaced with a metal socket, and the socket of the shoulder is replaced with a metal ball. The implants used are made of titanium or cobalt chrome. They are often cemented in place for additional stability. Patients are often placed in a sling for comfort after surgery. With the reverse total shoulder, you will use accessory shoulder muscles such as the deltoid to raise your arm in the absence of the rotator cuff.

Open Biceps Tendon Repair

Biceps tenodesis is an open procedure, meaning it requires either one or two incisions. Reattachment at the shoulder is done through an approximately half-inch incision on the inside of the arm close to the axilla. For reattachment at the elbow, a two-incision approach is utilized. At the elbow, the first incision is at the crease where the elbow bends. The second incision is on the back of the forearm. Regardless the number of incisions, the surgery is similar. First the ruptured tendon is located by the surgeon. Once located, the end of the tendon is cleared of any damaged tissue so the tendon has a fresh edge. Then the end of the tendon is reattached down to the bone with strong suture known as Fiberwire. If necessary, an additional screw or peg may be inserted for extra fixation of the tendon to bone.

Rotator Cuff Arthropathy

Rotator cuff arthropathy is a condition resulting from long-standing rotator cuff tears in the shoulder. Patients develop a severe loss of motion of the arm and weakness and will experience difficulty and pain with lifting, pushing, and pulling motions. There are both non-operative and surgical treatments for this condition.

Latarjet

Latarjet is an open procedure for the shoulder where the coracoid process of the shoulder is cut. The bone that is cut is then placed over the front of the shoulder joint and secured with a screw. This piece of bone now acts as a wall in the front of your shoulder that will stabilize the shoulder joint and prevent any instability or dislocation from occurring.

SLAP / Labrum Tear

The labrum is a pad of cartilage that lines the shoulder joint. Commonly, patients will injure the labrum as a result of repetitive motion such as throwing or swimming. A “SLAP” tear is a frequently used term to describe a tear that extends from the front of the back of the labrum. Treatment for labral tears involves medications, physical therapy, and possibly arthroscopic surgery.

Arthroscopic Capsular Release

In order to resolve the stiffness associated with adhesive capsulitis, capsular release (cutting of the tissue that encompasses the joint) is performed to break up the inflamed scar tissue in the shoulder and allow the shoulder to move more freely. Depending on how stiff the shoulder is prior to surgery, a manipulation of the shoulder may be performed, which involves moving the shoulder around through all ranges of motion to help alleviate the stiffness in the shoulder.

Rotator Cuff Tear / Tendonitis

Rotator cuff tendonitis describes the inflammation of the rotator cuff muscles in the shoulder and is often caused by repetitive pushing, pulling, or heavy lifting activities. Tendonitis can lead to tears of the rotator cuff and a person may develop weakness in his/her arm because of the tear. Rotator cuff tear and tendonitis are treated with physical therapy, medications, and sometimes arthroscopic surgery.

Arthroscopic Subacromial Decompression

Shoulder arthroscopy with a subacromial decompression involves first, cleaning out the shoulder of any debris or inflamed tissue. Then, by using a small shaver device, the undersurface layer of the acromion is removed. The space below the acromium where the rotator cuff passes is thus made wider. By doing this, the rotator cuff can freely pass without rubbing on bone and becoming inflamed or impinged.

Osteoarthritis (OA) of the Shoulder

Osteoarthritis of the shoulder is the loss of cartilage that covers the ball and socket of the shoulder joint. Patients will experience stiffness, pain in the shoulder, upper arm, and neck and can often have trouble performing over head activities or lifting heavy items. Treatment for shoulder osteoarthritis includes physical therapy, medications, injections, and possibly surgery.