Please scroll through this page to view the various shoulder treatment options available at Spine & Sports Medical Group.
Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small incision (cut) in your skin.
What happens during the procedure?
First, we examine your shoulder with the arthroscope. Then we:
- Insert the arthroscope into your shoulder through a small incision. The arthroscope is connected to a video monitor in the operating room.
- Inspect all the tissues of your shoulder joint and the area above the joint -- the cartilage, bones, tendons, and ligaments.
- Repair any damaged tissues. To do this, your surgeon will make 1 to 3 more small incisions and insert other instruments through them. A tear in a muscle, tendon, or cartilage will be fixed. Damaged tissue may need to be removed.
We can then do one or more of the following procedures during your surgery:
- Rotator cuff repair: The edges of the muscles are brought together. The tendon is attached to the bone with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic. They do not need to be removed after surgery.
- Surgery for impingement syndrome: Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. Your surgeon may also cut a specific ligament, called the coracoacromial ligament, and shave off the under part of a bone. This under part of the bone is called the acromion.
- Surgery for shoulder instability: If you have a torn labrum, the rim of the shoulder joint that is made out of cartilage, your surgeon will repair it. Ligaments that attach to this area will also be repaired. The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.
At the end of the surgery using the arthroscope, your incisions will be closed with stitches and covered with a dressing (bandage).
We may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues. Open surgery is a more complicated surgery.
For detailed information about this condition and treatments please visit: AAOS Online Service Fact Sheet - Shoulder Surgery
Rotator Cuff Repair
Rotator cuff repair is a type of surgery to fix a torn tendon in the shoulder. The procedure can be done with a large ("open") incision or with shoulder arthroscopy, which uses small button-hole sized incisions.
What happens during the procedure?
First, we check your shoulder with a small camera (arthroscope) to look at the tear and determine if it can be fixed. The arthroscope is inserted into the shoulder through a small poke-hole. The camera is connected to a video monitor. The surgeon looks around the entire joint to check the cartilage, tendons, and ligaments of your shoulder.
After evaluating the shoulder joint, the surgeon places the camera in the space above the rotator cuff tendons, called the subacromial space. The surgeon can check the area above the rotator cuff, clean out inflamed or damaged tissue, and remove a bone spur (subacromial spur).
If a tear is going to be fixed, the surgeon may perform the surgery with a larger, open incision. Other surgeons use the arthroscope and 1 to 3 additional small poke-holes or smaller incisions to perform the surgery. The additional small incisions allow the surgeon to insert other instruments to repair damaged tissue.
The goal is to attach the tendon back to the bone where it tore off. The tendon is attached with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The suture anchors can be made of metal or material that dissolves over time, and do not need to be removed. At the end of the surgery, the incisions are closed, and a dressing is applied. If arthroscopy was performed, most surgeons take pictures of the procedure from the video monitor to show you what was found and what was done.
For detailed information about this condition and treatments please visit: AAOS Online Service Fact Sheet - Rotator Cuff Tears
Advances in medical technology are enabling doctors to identify and treat injuries that went unnoticed 20 years ago. For example, physicians can now use miniaturized television cameras to see inside a joint. With this tool, they have been able to identify and treat a shoulder injury called a glenoid labrum tear.
The symptoms of a tear in the shoulder socket rim are very similar to those of other shoulder injuries. Symptoms include
- Pain, usually with overhead activities
- Catching, locking, popping, or grinding
- Occasional night pain or pain with daily activities
- A sense of instability in the shoulder
- Decreased range of motion
- Loss of strength
For detailed information about this condition and treatments please visit: AAOS Online Service Fact Sheet - Shoulder Joint Tear (Glenoid Labrum Tear)
The shoulder is the most moveable joint in your body. It helps you lift your arm, rotate it, and reach up over your head. It is able to turn in many directions. This greater range of motion, however, results in less stability.
Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse. Once a shoulder has dislocated, it is vulnerable to repeat episodes. When the shoulder is loose and slips out of place repeatedly, it is called chronic shoulder instability. Chronic shoulder instability is often first treated with nonsurgical options. If these options do not relieve the pain and instability, surgery may be needed.
Your doctor will develop a treatment plan to relieve your symptoms. It often takes several months of nonsurgical treatment before you can tell how well it is working.
Surgery is often necessary to repair torn or stretched ligaments so that they are better able to hold the shoulder joint in place.Bankart lesions can be surgically repaired. Sutures and anchors are used to reattach the ligament to the bone.
For detailed information about this condition and treatments please visit: AAOS Online Service Fact Sheet - Chronic Shoulder Instability
Shoulder Impingement and Bursitis
Impingement is one of the most common causes of pain in the adult shoulder. It results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted.
The rotator cuff is a tendon linking four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. These muscles cover the "ball" of the shoulder (head of the humerus). The muscles work together to lift and rotate the shoulder.
The acromion is the front edge of the shoulder blade. It sits over and in front of the humeral head. As the arm is lifted, the acromion rubs, or "impinges" on, the surface of the rotator cuff. This causes pain and limits movement.
The pain may be due to a "bursitis," or inflammation, of the bursa overlying the rotator cuff or a "tendonitis" of the cuff itself. In some circumstances, a partial tear of the rotator cuff may cause impingement pain.
For detailed information about this condition and treatments please visit: AAOS Online Service Fact Sheet - Shoulder Impingement
The shoulder joint is the body's most mobile joint. It can turn in many directions. But, this advantage also makes the shoulder an easy joint to dislocate. A partial dislocation means the head of the upper arm bone is partially out of the socket. A complete dislocation means it is all the way out of the socket. Both partial and complete dislocation will cause pain and unsteadiness in the shoulder.
How does it occur?
The shoulder joint can dislocate forward, backward, or downward. A common type of shoulder dislocation is when the shoulder slips forward (anterior instability). This means the upper arm bone moved forward and down out of its joint. It may happen when the arm is put in a throwing position.
How is it treated?
We may immobilize the shoulder in a sling or other device for several weeks following treatment. Plenty of rest is needed. The sore area can be iced 3 to 4 times a day.
After the pain and swelling go down, the doctor will prescribe rehabilitation exercises for you. These help restore the shoulder's range of motion and strengthen the muscles. Rehabilitation may also help prevent dislocating the shoulder again in the future. Rehabilitation will begin with gentle muscle toning exercises. Later, weight training can be added.
If shoulder dislocation becomes a chronic condition, a brace can sometimes help. However, if therapy and bracing fail, surgery may be needed to repair or tighten the torn or stretched ligaments that help hold the joint in place, particularly in young athletes.
For detailed information about this procedure please visit: AAOS Online Service Fact Sheet - Dislocated Shoulder
Total Shoulder Replacement
Shoulder replacement is surgery to replace the bones of the shoulder joint with artificial joint parts.
What happens during the procedure?
You may receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to help you relax during the operation.
The shoulder is a ball and socket joint. The round end of one bone fits into a cavity, or socket, at the end of another bone. This type of joint allows you to move your arm in most directions.
For total shoulder replacement, the round end of your arm bone will be replaced with an artificial stem that has a rounded metal head. The socket part of your shoulder joint will be replaced with a smooth plastic shell (lining) that will be held in place with special cement. If only 1 of these 2 bones needs to be replaced, the surgery is called a partial shoulder replacement.
For shoulder joint replacement, your surgeon will make an incision (cut) over your shoulder joint to open up the area. Then your surgeon will:
- Remove the head (top) of your upper arm bone
- Cement the new metal head and stem into place
- Smooth the surface of the old socket and cement the new shell in place
- Close your incision with staples or sutures
- Place a dressing (bandage) over your wound
Your surgeon may place a drain in this area to carry out fluid that may build up in the joint. The drain will be removed when you no longer need it.
This surgery usually takes 1 to 3 hours.
For detailed information about this procedure please visit: AAOS Online Service Fact Sheet - Shoulder Joint Replacement