The shoulder joint is a ball-and-socket joint, much like the hip joint. The ball is the top of the arm bone (humerus), and the socket is within the shoulder blade (scapula). This joint allows people an enormous range of motion at the shoulder. When shoulder replacement surgery is performed for severe arthritis, the ball is removed from the top of the humerus and replaced with a half-moon shaped metal implant. The implant is attached to a stem inserted down the center of the arm bone. The socket portion of the joint is shaved clean and replaced with a plastic socket that is cemented into the scapula.
There are two common types of shoulder replacements:
Standard Total Shoulder Arthroplasty: Designed for patients with an intact rotator cuff.
Reverse Total Shoulder Arthroplasty: Designed for patients with severe and complete rotator cuff tears.
Arthroscopy of the shoulder is a minimally invasive technique of treating rotator cuff tears, bursitis, cartilage defects, and labral tears. The arthroscopic approach results in a quicker recovery and improved early outcomes.
Conditions treated with shoulder arthroscopy include:
Rotator cuff tears
Stiffness (Adhesive Capsulitis / Frozen Shoulder)
Rotator Cuff Repair
Four important muscles originate on the scapula and attach to the humerus. Where their tendons fuse together on the humerus is called the rotator cuff. All of these components of your shoulder work together to create a normally functioning shoulder.
Symptoms of a rotator cuff tear may develop after an injury, such as a lifting a heavy object or a fall, or develop gradually with repetitive overhead activity. It is common for the pain to start in the side of the shoulder and radiate down the side of the upper arm. At first, the pain may be mild and only occur with overhead activities such as reaching or lifting. In addition, night pain and difficulty sleeping are very common complaints. It may be relieved by over-the-counter medication such as aspirin or ibuprofen.
Some of the signs of a rotator cuff tear include:
Atrophy or thinning of the muscles about the shoulder
Pain when lifting the arm
Pain when lowering the arm from a fully raised position
Weakness when lifting or rotating the arm
Night pain, Difficulty sleeping
Rotator cuff tears can be repaired with arthroscopic or open surgical techniques. Dr. Hurst will advise you on the best course of action when he see you for your appointment.
The shoulder joint has a very shallow socket (the glenoid). To compensate for the shallow socket, there is a ring of flexible cartilage around the socket called the labrum that helps create a deeper cup for the ball of the humerus.
The shoulder labrum can become torn during a shoulder dislocation, and this labral tear is called aBankart Lesion. Symptoms of a Bankart Lesion are persistent feelings of shoulder instability, pain in the front of the shoulder, or a general feeling of apprehension that the patient “cannot trust his/her shoulder”.
In addition, one of the biceps tendons attaches to the top of the labrum in the shoulder. A forceful biceps contraction from a fall or from repetitive overhead activities can cause a traction injury at the top of the labrum. This type of labral tear is called a SLAP Lesion. Symptoms of a SLAP tear include pain or catching in the front of the shoulder made worse with bending of the elbow and rotation of the wrist.
While physical therapy and injection treatments can help symptoms of a Bankart or SLAP Lesion, surgical repair is often necessary. There are multiple factors that go into the decision for surgical repair; however, most of the repair techniques can be done arthroscopically with patients going home the same day of surgery.