Shoulder
Shoulder pain and discomfort can be very uncomfortable. The team of highly-skilled orthopedic surgeons at Aligned Orthopedic Partners can diagnose and treat your shoulder condition so you can gain back the use and mobility of your shoulder.
Shoulder Conditions & Treatments:
What is Frozen Shoulder?
Your shoulder joint is a ball-and-socket structure where the rounded head of your humerus (upper arm bone) articulates with the glenoid fossa (part of your shoulder blade). This joint is surrounded by a flexible structure called the joint capsule. Frozen shoulder occurs when the joint capsule becomes inflamed, thickened, and contracted, significantly restricting your shoulder’s range of motion.
Why Does Frozen Shoulder Happen?
We don’t fully understand why some people get frozen shoulder, but it seems to be a mix of things you’re born with and factors in your life.
What Does Frozen Shoulder Feel Like?
Frozen shoulder usually goes through three phases:
- Freezing: This starts with a lot of pain, especially at night, that makes it hard to move your shoulder. This phase can last a few months.
- Frozen: The pain lessens, but your shoulder gets really stiff. It’s like it won’t budge, and everyday tasks become difficult. This can last for several months.
- Thawing: Slowly, you start to regain some movement. It might take a long time, but most people eventually get much better.
Important Things to Know:
- Talk to your doctor: They can diagnose frozen shoulder and help you manage the pain and stiffness.
- There are treatments: Physical therapy, stretches, and sometimes medication or injections can help you get through the tough phases.
- Patience is key: Frozen shoulder often gets better on its own, but it can take time.
Understanding Shoulder Arthritis
Your shoulder joint is a ball-and-socket joint where your upper arm bone (humerus) fits into a cup-shaped part of your shoulder blade (scapula). Arthritis involves the deterioration of the smooth cartilage that lines the bones within the joint, leading to pain, stiffness, and reduced mobility.
Types of Shoulder Arthritis
- Osteoarthritis: The most common type, often associated with age and wear-and-tear.
- Rheumatoid Arthritis: An autoimmune disease where the body attacks its joint lining, causing inflammation.
- Post-Traumatic Arthritis: Develops after a significant injury to the shoulder, like a fracture or dislocation.
Rotator Cuff Tear Arthropathy: A less common form associated with large, longstanding rotator cuff tears.
Signs and Symptoms
- Pain: Often a dull ache deep in the shoulder. May worsen with activity or at night.
- Stiffness: Reduced range of motion, making it difficult to reach overhead, behind your back, or perform daily tasks.
- Weakness: As the condition progresses, you may have weakness in the shoulder muscles.
- Grinding or Popping: You might feel or hear these sensations as you move your shoulder.
How is Shoulder Arthritis Diagnosed?
Your doctor will:
- Discuss Your Symptoms: The details of your pain and how it affects your daily life are important.
- Physical Exam: They will check your range of motion, assess for areas of tenderness, and evaluate your shoulder strength.
- Imaging Tests: Usually starting with X-rays, but MRI or CT scans might be needed for a more detailed evaluation.
Treatment: Managing Pain and Preserving Function
Treatment typically starts with conservative approaches:
- Rest and Activity Modification: Avoiding aggravating activities and finding new ways to perform daily tasks.
- Medication: Over-the-counter or prescription painkillers and anti-inflammatories.
- Physical Therapy: Specific exercises to strengthen the muscles supporting your shoulder joint and improve range of motion.
- Injections: Cortisone injections can provide temporary pain relief.
Orthobiologic injections (like PRP) may help promote healing.
When Surgery Might be Necessary
If nonsurgical treatments don’t sufficiently improve pain and function, your doctor might recommend surgery. Options include:
- Shoulder Arthroscopy: To clean out the damaged joint.
- Shoulder Replacement: Replacing the ball-and-socket with artificial components.
What to Remember:
- Early diagnosis helps: Treatment can slow the progression of arthritis and preserve shoulder function.
- Don’t ignore the pain: Seek medical advice to discuss your options.
- Many treatment options exist: You and your doctor will create a personalized plan.
Understanding Rotator Cuff Tears
Your rotator cuff is a group of muscles and tendons that surround your shoulder joint and provide stability, allowing you to lift and rotate your arm. A rotator cuff tear happens when one or more of these tendons become damaged, causing pain, weakness, and difficulty with everyday movements.
How Do Rotator Cuff Tears Happen?
There are two main types of rotator cuff tears:
- Degenerative Tears: The most common type. These happen due to gradual wear and tear over time as we age.
- Acute Tears: Occur suddenly due to a fall, lifting a heavy object, or other forceful injury to the shoulder.
Symptoms of a Rotator Cuff Tear
- Pain in the shoulder, often worse at night or when lifting or reaching overhead.
- Weakness when lifting your arm or rotating it.
- A clicking or catching sensation when moving your shoulder.
- Decreased range of motion in the shoulder.
Diagnosis and Treatment
Physical Exam: Your doctor will check your strength and range of motion, looking for specific signs of a rotator cuff injury.
Imaging: An MRI is often used to confirm the tear, determine its size and location, and assess how severe it is.
Treatment Options
Treatment depends on the severity of the tear, your age, and activity level.
Nonsurgical Approaches:
Rest: Avoiding activities that worsen pain.
Pain relievers and anti-inflammatory medications.
Physical therapy: Specific exercises to strengthen the rotator cuff and other shoulder muscles.
Injections: Cortisone injections may provide temporary pain relief.
Surgical Repair: If nonsurgical treatments fail to provide enough relief, surgery may be needed to sew the torn tendon back together. This can be done arthroscopically (minimally invasive) or through a traditional open approach.
Important Points
Don’t Ignore Shoulder Pain: Early evaluation and treatment can lead to better outcomes.
Some Tears Heal Without Surgery: Many people improve with nonsurgical management, especially smaller tears.
Physical Therapy is Key: It’s crucial for both nonsurgical and surgical recovery, helping you regain strength and range of motion.
Talk to Your Doctor
If you suspect a rotator cuff tear, get it evaluated. Your doctor will help you understand the severity of the injury and discuss the best treatment approach for your individual case.
Could PRP Help Your Shoulder Arthritis?
Shoulder arthritis involves the breakdown of cartilage within the joint, leading to pain, stiffness, and reduced mobility. If traditional treatments like rest, medication, and physical therapy haven’t brought enough relief, PRP might offer a potential solution.
What is PRP and How Might It Help?
PRP (Platelet-Rich Plasma): A concentrated solution derived from your own blood that’s packed with platelets.
Power of Platelets: Platelets contain growth factors, which play a vital role in your body’s healing processes.
PRP Aims for Shoulder Arthritis: When injected into your arthritic shoulder joint, PRP aims to:
- Reduce inflammation and pain
- Potentially promote new cartilage growth in mild to moderate arthritis
- Slow down the progression of the disease
Is PRP Right for Your Shoulder Arthritis?
You might be a good candidate for PRP therapy if:
- Your shoulder arthritis is mild to moderate.
- Conservative treatments haven’t provided adequate pain relief.
- You’re not yet ready for surgery or want to explore less invasive options first.
- The PRP Procedure for Shoulder Arthritis
Consultation: Your doctor will evaluate your condition to ensure PRP is suitable.
Blood Draw: A small amount of blood is taken.
Preparation: The blood is spun in a centrifuge to isolate the platelets and create the PRP.
Injection: Using ultrasound or X-ray guidance for precision, the PRP is injected into your shoulder joint.
Recovery: You might experience temporary soreness, but recovery is usually quick. Combining PRP with physical therapy often enhances your results.
Important Considerations
PRP is Safe: As it uses your own blood, there’s minimal risk of side effects.
Emerging Research: Studies suggest that PRP can be an effective treatment for shoulder arthritis, reducing pain and improving function.
Not a Quick Fix: It takes time for the growth factors to stimulate healing. Multiple PRP injections might be recommended for the best results.
Discuss PRP with Your Doctor
If you’re struggling with shoulder arthritis pain, ask your doctor about PRP therapy. They can help you assess if it’s the right approach for your situation.
A partial rotator cuff tear means one of the tendons in your shoulder is damaged, but not completely torn. These tears can cause pain, weakness, and difficulty with overhead activities. If rest, physical therapy, and medication haven’t brought enough relief, PRP (Platelet-Rich Plasma) therapy offers a potential non-surgical solution.
How Can PRP Help a Partial Rotator Cuff Tear?
Targeted Healing: PRP delivers a concentrated dose of your own growth factors directly to the site of the tear. Growth factors play a crucial role in tissue repair.
Goals of PRP:
- Reduce inflammation and pain
- Stimulate the body’s natural healing process within the damaged tendon
- Potentially promote long-term strengthening of the tendon
Is PRP Right for Your Partial Rotator Cuff Tear?
You might be a good candidate for PRP if:
- Traditional treatments haven’t helped enough with pain and improved function.
- You have a confirmed partial tear, ideally identified on an MRI.
- You want to explore a minimally invasive option before considering surgery.
- You are willing to actively participate in physical therapy after the procedure.
The PRP Process for Partial Rotator Cuff Tears
Evaluation: Your doctor will confirm the diagnosis and determine if PRP is suitable.
Blood Draw: A small sample of blood is taken.
Preparation: The blood is processed to concentrate the platelets and create the PRP.
Injection: Using ultrasound guidance for accuracy, your doctor precisely injects the PRP into the damaged area of the rotator cuff tendon.
Recovery: You might feel some initial soreness, but recovery is often quick. Physical therapy is crucial for optimal results.
Important to Remember
PRP is Safe: As it uses your own blood, there’s minimal risk of side effects.
Research is Encouraging: While more research is ongoing, studies suggest PRP can be an effective treatment for partial rotator cuff tears.
Results May Vary: Healing takes time and individual responses can differ.
Ask Your Doctor
If you’re frustrated with persistent pain and limitations from a partial rotator cuff tear, discuss PRP therapy with your doctor. They can evaluate your condition and help you decide if it’s a worthwhile option for your recovery journey.
Understanding Shoulder Instability
Normally, the upper part of the upper arm bone fits snugly into the hollow of the shoulder blade.
However, in cases of shoulder instability, the shoulder dislocates, indicating damage to shoulder structures such as the rotator cuff and joint capsule.
This condition can lead to shoulder dislocation, which restricts the range of motion in your shoulder and causes difficulties in using your arm.
What Are The Symptoms?
If you are not sure about whether or not you are experiencing shoulder instability, there are a number of indicators to look out for:
- Your shoulder consistently dislocates or pops out of its socket.
- You may experience feelings of weakness in the shoulder, as if it is not properly aligned.
- Pain in the shoulder area is also a common symptom.
Treatment for Shoulder Instability:
- Physical Therapy: Strengthening exercises for shoulder muscles.
- Activity Modification: Avoidance of exacerbating activities.
- Immobilization: Use of sling or brace for rest.
- Medication: NSAIDs for pain and inflammation.
Rehabilitation: Gradual return to activities under supervision. - Follow-up: Regular monitoring by healthcare provider.
Arthroscopic Shoulder Stabilization Surgery
What Is Shoulder Arthroscopy for Pain Relief?
Arthroscopy is a procedure we perform that is minimally invasive, aiming to identify the underlying cause of joint issues.
Our surgeons utilize a small instrument called an arthroscope, which serves as both a diagnostic tool and a potential surgical treatment.
By inserting the arthroscope, equipped with a light and camera system, into your shoulder joint, your surgeon can visualize the affected area projected onto a monitor. This technique enables your doctor to diagnose and address various shoulder conditions and injuries involving the joint’s bones, cartilage, muscles, ligaments, and tendons.
Conditions and Symptoms Treated By Shoulder Arthroscopy
Shoulder arthroscopy is a procedure used to treat various conditions and symptoms that affect the shoulder joint. The shoulder joint is formed by the upper arm bone and the shoulder blade, and it relies on cartilage to ensure smooth movement. Ligaments and tendons provide stability and strength to the joint. There are several injuries and diseases that can affect the bones and tissues of the shoulder joint, leading to pain, inflammation, and mobility problems.
When conservative treatments fail to provide relief, shoulder arthroscopy may be recommended. This procedure can address conditions such as:
- arthritis of the shoulder joint or collar bone
- shoulder impingement
- rotator cuff tears
- stiffness
- frozen shoulder
- instability of the shoulder joint
- biceps rupture
- bone spurs
- damage to cartilage or ligaments
The Procedure
If you and your orthopedic surgeon at decide to undergo shoulder arthroscopy for your joint problems, your doctor will ensure that you have a clear understanding of the procedure beforehand so that you know what to expect.
Generally, the process is as follows:
Shoulder arthroscopy can be performed using either general anesthesia or regional anesthesia.
Typically, patients are positioned lying on their side, with the affected arm supported.
However, you may also be placed in a semi-seated position. To create a clear view of the damaged area and provide your surgeon with enough space to work, your shoulder joint is injected with sterile fluid.
A small hole, about the size of a button, is made for the insertion of the arthroscope.
Using the camera in the arthroscope, your surgeon can view images on a large monitor.
Additional small holes are created to insert surgical instruments that will be used by your physician to repair the damage in your shoulder joint.
Once the surgery is finished, all instruments are removed and the small holes are closed either with stitches or sterile bandage strips.
Post-Surgery Recovery
After undergoing shoulder arthroscopy surgery, it will take a few days for the small wounds to heal. During this time, you may experience pain or discomfort, which can be managed with prescribed pain medication.
Important to Note:
The duration of your recovery depends on the severity of the underlying shoulder issues that were treated during the surgery.
It may be necessary to wear a sling to support your arm as you recover.
Physical therapy will begin soon after the surgery to improve your shoulder’s mobility and strengthen the joint.
It is crucial to actively participate in physical therapy to prevent stiffness after the operation.
Like any surgical procedure, there are potential complications to be aware of, including stiffness, infection, bleeding, and damage to nearby blood vessels or nerves. It is also possible for healing to be delayed following the procedure.
What Are The Advantages of Shoulder Stabilization Surgery?
There are many benefits of shoulder arthroscopy for patients, particularly when compared to open shoulder surgery that requires a large incision. These advantages include:
- Reduced risk of surgical complications
- Shorter hospital stay
- Quicker recovery period
- Decreased pain levels
Why Choose Aligned Ortho for Shoulder Stabilization Surgery?
We specialize in minimally invasive arthroscopic shoulder instability surgery. Our experience allows us to understand and empathize with your circumstances. Our goal is to help you heal. Our physicians explain the procedure in simple language, avoiding complex medical terms. We encourage questions to ensure you understand every aspect of the surgery.
If you have shoulder discomfort from the bicep tendon, you may need biceps tenodesis or tenotomy. This could be due to degeneration, inflammation from injury or overuse, or natural aging. At Aligned Orthopedic Partners, our orthopedic surgeons provide top-notch services and are ready to assist with biceps tenodesis or tenotomy treatment.
What Are Biceps Tenodesis & Tenotomy
Biceps tenodesis repairs the tendon linking the biceps to the shoulder.
The biceps’ lengthy head connects to the upper part of the glenoid, or shoulder socket, and is prone to tears, strains, and inflammation.
Both procedures involve severing the tendons from the glenoid cartilage.
In tenodesis, the tendons are reattached to the upper arm bone.
In tenotomy, they heal naturally over several weeks.
A tenotomy allows the biceps to function but may flatten the muscle.
For sedentary individuals, a tenotomy may suffice, but athletes typically opt for tenodesis.
Common Reasons For This Procedure
- Alleviates pain from bicep tendon injury, inflammation, or tears.
- Commonly recommended for severe pain in the biceps tendon at the shoulder’s front or uppermost part.
- The pain may be especially intense at night, and may extend to other arm areas.
- Patients who might require this procedure may also experience swelling, tingling, cramping, and difficulty moving arms or shoulders.
The Procedure: Exploring Techniques
Biceps tenodesis is performed under general anesthesia using different methods, such as:
The Pitt technique: This involves creating an interlocking suture pattern and securing the tendon to the shoulder ligament using soft tissue techniques.
Open keyhole procedure: Another soft technique where the surgeon makes a small opening in the humerus, rolls up one end of the bicep, and sutures it in position.
Post-Procedure Recovery
Patients will wear a sling for approximately six weeks to support tissue healing and restrict arm movement.
After this, they can gradually increase arm range of motion with a physical therapist.
Regular training sessions can improve shoulder, arm, and hand strength and expand range of motion.
Full recovery takes around 20 weeks, varying based on factors like rehabilitation program, age, injury severity, and overall health.
Labrum Repair Surgery
If you experience a popping noise whenever you change the position of your arm, it is possible that you have a tear in your labrum. Labrum repair surgery is a highly effective procedure that can restore mobility and provide complete relief from pain in the affected area.
Symptoms of a Torn Shoulder Labrum
If you experience discomfort in your shoulder joint, it can be challenging to determine if you have a labrum tear without a proper diagnosis from a medical professional.
Nevertheless, there are certain indicators that suggest the possibility of a torn labrum:
- Experiencing pain when raising your arm above your head.
- Finding it difficult to engage in sports that require repetitive arm movements, such as baseball or softball.
- Feeling deep-seated shoulder pain.
Experiencing discomfort and weakness in the shoulder when carrying weight. - Hearing clicking, popping, or grinding sounds when moving your shoulder.
Can a Torn Labrum Be Fixed?
Yes, a torn labrum can be repaired through comprehensive examination and diagnosis followed by corrective surgery.
Imaging tests like CT scans or MRIs are necessary for an accurate diagnosis.
Shoulder arthroscopy may also be required.
Torn Labrum Repair Surgery
A torn labrum will be restored through labrum repair surgery.
Treatment options vary depending on the type of tear, with minor tears often being repaired using arthroscopic techniques and smaller incisions
For more severe tears, a larger incision and an open operation may be necessary.
A skilled orthopedic surgeon will perform your shoulder arthroscopy using a minimally invasive technique.
Recovery
Recovery time for labrum repair surgery is usually 4-6 weeks for the cartilage to reattach to the bone rim, followed by another 6 weeks to regain full strength. The healing process takes about 3 months. It’s important to avoid stressing the shoulder to prevent re-injury to the labrum.
Important To Note
If left untreated, a labral tear can cause shoulder joint irritation, leading to locking and jamming sensations.
This can create a feeling of misalignment within the joint.
Additionally, untreated labral tears may increase joint friction and the risk of developing shoulder arthritis.
Latarjet Procedure
Experiencing a shoulder dislocation can be very painful and may cause complications. It happens when the humerus bone is pushed out of its socket in the shoulder joint, usually from falling or stretching incorrectly.
The most common type is anterior dislocation, but there are other types as well. If you often have shoulder dislocations, you might be a good candidate for anterior shoulder instability surgery, also called a Latarjet procedure.
At Aligned Orthopedic Partners, we provide excellent treatment for shoulder instability, including Latarjet procedures. Our experienced team has done many surgeries like this and will guide you through the whole process. We aim to make your experience as comfortable as possible.
Symptoms Of A Shoulder Dislocation
Signs indicating a potential shoulder dislocation and the need for treatment include:
- Severe pain that may extend from the shoulder down the arm
- Numbness in the arm
- Sensation of the shoulder popping out of its joint
- Visual observation of a misaligned shoulder, resulting in a squared appearance.
What To Do If You’ve Dislocated Your Shoulder
Immediate Medical Assistance:
- Crucial to seek immediate medical help for shoulder dislocation due to intense pain.
- Inability to move the arm and possible deformity in the affected shoulder are common symptoms.
- Numbness in hand or arm may occur.
Emergency Response:
- Most physicians’ offices are not equipped to handle shoulder dislocations.
- Secure arm with a sling, belt, or sheet until reaching emergency care.
- Vital to have someone take you to an emergency room or urgent care facility.
Initial Treatment:
Medical professionals will attempt to reposition your shoulder and place your arm in a sling.
Follow-up with an orthopedic surgeon advised.
Home Care:
- Apply an ice pack wrapped in a towel to your shoulder for 20 minutes every few hours.
- After 2-3 days, consider using a hot pack for tight muscles.
- Continue wearing sling, even during sleep.
- Over-the-counter pain medications can help manage discomfort.
What To Expect for Anterior Shoulder Instability Surgery
Before considering surgery, alternative options such as physical therapy will be explored, with a preference for conservative approaches.
During the surgical procedure, a protective barrier is established at the front of the shoulder to prevent slippage, and a piece of bone is harvested from another area of the body and grafted onto the front of the shoulder socket to enhance stability.
Following the surgery, patients may experience a reduced range of motion in the shoulder, and it may take up to six months for full recovery.
However, the surgery has a high success rate and can significantly decrease the likelihood of future shoulder dislocations.
Why Choose Aligned Orthopedic Partners?
Choosing our orthopedic practice for shoulder dislocation treatment has several advantages:
Our experienced team has performed many successful Latarjet procedures, so they have extensive knowledge about this surgical technique.
Our doctors make sure to communicate openly with patients, answering any questions or concerns they may have before and after the procedure.
You can trust that we provide caring and dedicated care.
The Remplissage Procedure
If you have a Hill-Sachs lesion in your shoulder, a Remplissage procedure may be necessary for effective treatment. Our team at Aligned Orthopedic Partners is dedicated to delivering compassionate care and restoring full functionality to your shoulder as quickly as possible.
Physicians often use the Remplissage procedure with arthroscopic Bankart or arthroscopic anterior stabilization surgery to reduce the risk of shoulder instability.
Understanding The Arthroscopic Remplissage Technique
The Arthroscopic Remplissage technique is used for significant Hill-Sachs lesions in the shoulder. This technique doesn’t require additional incisions.
An arthroscope is inserted into the front portal to visualize the lesion.
A burr is used to remove damaged tissue, and a large anchor is inserted into the defect.
Sutures are passed through the capsule and tendon and secured using a parachute technique.
What Are The Benefits?
The Remplissage procedure has many benefits for patients. One of its main advantages is that it can fix the Hill-Sachs defect without having to manipulate the front part of the shoulder socket. This makes it a good option for people who have instability issues because of prominent Hill-Sachs lesions.
These patients usually have a higher risk of the procedure not working compared to those with smaller lesions. By using the Remplissage technique, the chance of the problem coming back is significantly reduced compared to surgeries that only involve arthroscopic Bankart repair.
Recovery Time
The recovery time for the Remplissage procedure varies depending on the severity, extent, and type of injury. Generally, it is shorter with Arthroscopic Remplissage compared to open surgery.
Patients commonly experience pain and discomfort for the first seven days following the surgery. During this time, the shoulder will need to be immobilized in a sling for four to six weeks, although patients over 50 may have the sling removed earlier to prevent stiffness.
Physical therapy will start after the doctor’s assessment and monitoring of progress. In the beginning, therapy will involve gentle passive movements without muscle use, moving onto limited motion exercises.
By the three-month mark, patients should be able to engage in moderate exercise to improve range of motion and muscle strength.
Additionally, your doctor will assist you in creating a comprehensive rehabilitation plan that aims to minimize the chances of experiencing complications like shoulder arthritis.
Reverse total shoulder replacement is a complex surgery for treating rotator cuff tear arthropathy. Unlike traditional shoulder replacement, it changes the placement of implant components and uses the deltoid muscle instead of the damaged rotator cuff muscles. This procedure helps patients with rotator cuff tear arthropathy regain movement and reduce pain. It is done when other treatments have been tried and didn’t work, and it requires skilled orthopedic surgeons. This surgery improves how well the shoulder works and your quality of life.
Indications That You May Require This Surgery
The signs of rotator cuff arthropathy include experiencing intense pain and weakness in the shoulder, particularly at night. You might have had rotator cuff repairs in the past. However, the most common sign is difficulty lifting your arm above your shoulder or participating in activities that involve reaching overhead.
Patients who may be candidates for reverse total shoulder replacement include those who are experiencing:
- Rotator cuff arthropathy
- Challenges in repairing a torn rotator cuff
- Unsuccessful shoulder replacement
- Intense shoulder pain
- Difficulties in performing overhead activities
- Persistent pain despite conservative treatment methods such as rest, medication, injections, or physical therapy
- Your Reverse Shoulder Replacement Procedure
If your Aligned Orthopedic Partners doctor recommends a reverse total shoulder replacement, they will discuss the procedure with you to ensure that you have a complete understanding beforehand.
Here are the general steps involved in the surgery:
- This surgical procedure is conducted under general anesthesia.
- The surgeon will create an incision on your affected shoulder in order to expose the joint.
- The upper arm bone, known as the humerus, will be separated from the socket of the shoulder blade.
- Any damaged tissue or arthritic parts of the humerus head and socket will be removed, and the area will be prepared for the insertion of artificial components.
- The implant consists of a metal ball that will be inserted into the shoulder socket, as well as a plastic cup that will be cemented into the upper arm bone.
- These components will be securely fixed in place.
- Once the underlying tissue has been replaced, the incision will be closed using sutures.
Recovery
After the surgery is complete, patients typically remain in the hospital for a period of one to two days. It is common for individuals to be able to get out of bed on the same day as the surgery. Once discharged, your doctor will recommend physical therapy to strengthen your shoulder and improve its flexibility. Following rehabilitation, most patients experience high levels of satisfaction as the procedure provides excellent pain relief and increased mobility.
Your doctor’s post-operative instructions may include:
- Taking pain medication as prescribed
- Performing prescribed exercises at home to enhance your range of motion
- Avoiding any overhead activities for a minimum of six weeks
- Refraining from using your shoulder muscles to push yourself up from a bed or chair
- Avoiding lifting heavy objects.
Risks
- Dislocation of the implanted joint.
- Joint instability.
- Risk of infection.
- Fractures to the humerus or scapula.
- Nerve or blood vessel damage.
- Formation of blood clots.
- Irritation to the wound.
- Discrepancy in arm lengths.
- Wear and tear of the implant components.
At Aligned Orthopedic Partners, we specialize in treating shoulder conditions, including rotator cuff arthropathy. If you suspect that you may have rotator cuff arthropathy, don’t hesitate to contact us. Reach out to us for information on reverse total shoulder replacement and other treatment options.
Understanding SLAP Repair:
If you feel pain lifting your arm or notice arm weakness, it’s smart to see a doctor to check for a labrum or SLAP tear.
At Aligned Orthopedic Partners, our specialized doctors treat various shoulder conditions, including SLAP repair, for Bethesda, MD residents.
SLAP stands for Superior Labrum Anterior and Posterior. A tear can happen where the biceps tendon connects to the labrum, at the upper, front, or rear region.
The labrum is crucial for shoulder stability. It’s a ring of strong tissue that lines the shoulder socket, providing cushioning. The biceps tendon connects to its upper part.
Causes of a SLAP Tear:
- Injury or excessive use can lead to a SLAP tear.
- Athletes engaged in sports involving repetitive arm swinging above the head, like tennis or baseball, are at higher risk.
- Other traumas such as falling on an outstretched arm or auto accidents can also cause a labral tear.
Aging-related fraying of the labrum is common in individuals over 30 years old.
What Does Torn Labrum Surgery Involve?
- Torn labrum surgery is recommended if other treatments don’t ease shoulder pain or improve function.
- After a thorough diagnosis, your doctor might suggest physical therapy to strengthen the rotator cuff and fix shoulder mechanics.
- If pain persists, surgery may be advised. Usually, SLAP repair is done using arthroscopic techniques, with a small camera and surgical tools.
- During the procedure, damaged labrum tissue is removed, and sutures attach it to an anchor on the shoulder bone.
- Sometimes, a biceps tenodesis is needed to detach the biceps tendon from the damaged labrum and reattach it lower on the humerus.
Recovery:
- The surgeon will close the incisions with sutures and apply a dressing to your shoulder.
- You will be required to wear a sling to keep your arm immobilized.
Once You Return Home:
- Keep your brace or sling on at all times, except when bathing. Your sling may need to be worn for a duration of up to four weeks.
- Make sure to keep your incision bandages dry and follow the doctor’s instructions for replacing them.
- Take the prescribed pain medication as directed.
- Avoid driving until your doctor gives you the green light.
Physical Therapy Exercises After Surgery:
- Your physical therapist will lead you through exercises to improve your range of motion.
- Starting these exercises immediately after surgery is crucial.
- After the sling is removed, focus shifts to exercises that strengthen and increase flexibility in your shoulder joint.
Success Rate
The success rate of shoulder labrum surgery is impressive, with over 90% of patients experiencing a full recovery and being able to resume their normal activities without any issues or the need for further surgery.
If you have persistent shoulder pain or limited arm movement, it could be due to arthritis or another shoulder complication. At Aligned Orthopedic Partners, our team specializes in orthopedic services and our skilled physicians can assess your condition and determine if total shoulder replacement surgery is necessary.
What is Involved in a Total Shoulder Replacement?
Your shoulder is a highly movable joint that allows your arm to move in different directions, like reaching above your head or grabbing objects far away. This joint is called a ball and socket joint, formed by the meeting of the upper arm bone (humerus) and the socket of the shoulder blade (scapula), known as the glenoid.
The meeting point of these bones is covered with cartilage, which prevents friction as the joint moves. Synovial fluid lubricates the cartilage, while tendons and ligaments provide strength and stability to the shoulder.
If any of these components are damaged, especially the cartilage, it can cause symptoms like pain, stiffness, or swelling, known as osteoarthritis. To relieve these symptoms, your Aligned Orthopedic Partners surgeon may recommend total shoulder replacement surgery, which involves removing the damaged parts of the shoulder joint and replacing them with artificial prosthetics.
What Conditions and Symptoms Does This Surgery Treat?
At our practice, we prioritize conservative treatment options for patients with osteoarthritis or rheumatoid arthritis. These options may include modifying activities, receiving injections, taking medication, or undergoing physical therapy. However, if you continue to experience certain symptoms, your physician may suggest total shoulder replacement:
- Shoulder pain that hinders your ability to carry out daily activities.
- Moderate or severe pain that persists even when you’re at rest.
- Weakness in the shoulder.
- Decreased range of motion in the shoulder joint.
How Does a Total Shoulder Replacement Work?
Procedure Overview:
- Total shoulder replacement surgery can be performed under regional or general anesthesia.
- The surgeon begins by creating an incision above the affected shoulder and separating the underlying muscle to access the joint.
- Depending on the condition, the surgeon may opt for open surgery or a minimally invasive procedure.
- Open surgery involves a larger incision, while minimally invasive techniques use an arthroscope and surgical tools inserted through small incisions.
Surgical Steps:
- The humerus is detached from the glenoid socket, and the damaged humeral head is removed.
- The bone is hollowed out and filled with cement before a metal ball with a connected stem is inserted into the humerus.
- Next, a plastic glenoid component is securely placed in the shoulder bone to replace the arthritic part of the socket.
Implantation Process:
After implanting the prosthetic components, the surgeon sutures the underlying joint capsule and closes the wound.
Recovery Process
After having shoulder replacement surgery, most patients stay in the hospital for a few days. During this time, your doctor will give you pain medicine to manage any discomfort and antibiotics to prevent infection.
After the surgery, your arm will be put in a sling or cast for a few weeks to make sure it heals properly. You will start rehabilitation right away, which includes physical therapy to make your shoulder stronger and more mobile. In about two to six weeks, you can start doing gentle daily activities.
Potential risks with total shoulder replacement are similar to those of any major surgery, which are:
- Nausea, vomiting, or dizziness due to anesthesia
Infection - Risk of shoulder dislocation
- Potential damage to muscles, nerves, or blood vessels
- Persistent pain
- Pulmonary embolism
- Wear and tear on the prosthetic components
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