When Surgery remains the joint arthritis, then the surgeon either performs Total Shoulder Replacement or shoulder Resurfacing. Shoulder Resurfacing is a better option than Total Shoulder Replacement when only one part of the joint is diseased.Shoulder Resurfacing preserves most of the natural tissues by replacing only the affected part of the joint baring the rest of the part to retain as natural. The Shoulder Resurfacing implant is designed to cap only the humeral head.
Shoulder Resurfacing Procedure is less traumatic, minimal invasive and a more bone preserving procedure. The hospitalization in this case is much lesser than required in Total shoulder Replacement.
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.
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, is 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 :
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:
• Minimally Invasive Surgery is performed by inserting special instruments and an arthroscope through small incisions in your shoulder. This approach is also known as arthroscopy. An arthroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your joints to a video screen viewed by your surgeon as he or she performs the surgery. Minimally invasive surgery generally involves a faster recovery, less pain, and less risk of complications than open surgery. This is because it causes less damage to tissues and organs. Your surgeonwill make small incisions instead of a larger one used in open surgery. He or she can then thread surgical tools around structures and organs instead of cutting through or displacing them as in open surgery.
• Mini-Open Surgery uses newer technology and combines minimally invasive arthroscopic techniques with a smaller open procedure. The incision is one to two inches long, which is smaller than a standard open surgery incision. This technique may allow some surgeons to make more extensive repairs than are possible with minimally invasive surgery. However, it causes less damage than traditional open surgery because your muscles remain attached during the surgery.
• Open Surgery : Open surgery may be necessary and, in some cases, may be associated with better results than arthroscopy. Open surgery often can be done through small incisions of just a few inches. Recovery and rehabilitation is related to the type of surgery performed inside the shoulder, rather than whether there was an arthroscopic or open surgical procedure.
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