Shoulder Surgery

Shoulder Surgery

Shoulder Surgery in Atlanta 

The orthopaedic surgery specialists at Barbour Orthopaedics maintain a high rate of success in shoulder surgery outcomes. They are committed to providing minimally invasive and traditional orthopaedic surgical solutions to help patients regain a full range of shoulder motion and return to an active, pain-free lifestyle. 

Shoulder Arthroscopy 

As with many other orthopaedic surgeries, arthroscopy has significantly increased the number of options surgeons have to treat injuries and conditions affecting the shoulder joint and rotator cuff. 

Shoulder surgeries that use to require invasive procedures, significant tissue damage and long, grueling recoveries can now be accomplished through small incisions with miniaturized arthroscopic instruments. These surgeries result in less blood loss, significantly less scarring, no hospital stays and faster return to work and day-to-day activities. 

           Common ways a Shoulder injury occurs



Repetitive Use



Repetitive use is a common cause of shoulder pain. People whose occupations require overhead work (plumbers, electricians, carpenters, etc.) are particularly susceptible to repetitive use injuries. Athletes who play sports that require overhead use of the shoulder (baseball, tennis, volleyball, swimming, etc.), can develop overuse injuries requiring surgical repair.


Degeneration



Over time, our bodies age. This includes the bones, muscles and tendons of the shoulder. Inflammation from “wear and tear” of the joints results in arthritis, whereas degeneration of the muscles and tendons results in tears that do not heal without surgical repair.



Trauma

Trauma is a leading cause of shoulder injury in young athletes

and older populations. Collisions and falls predispose the bones,

muscles, tendons and ligaments of the shoulder to damage,

frequently resulting in the need for surgical repair.



Not every patient who needs shoulder surgery is a good candidate for arthroscopy, but many shoulder problems can potentially be addressed with arthroscopy. Some examples of common shoulder arthroscopy procedures include:
  • Shoulder ligament repair
  • Rotator cuff repair
  • Labrum repair or removal 
  • Bone spur removal
  • Loose cartilage or inflamed tissue removal 
  • Recurrent shoulder dislocation repair
  • Shoulder fracture repair
  • Nerve release
  • Shoulder cyst excision

Shoulder Joint Replacement 

Although less common than knee or hip replacement, shoulder joint replacements can be a life-improving procedure for many people who have limited range of motion or chronic pain due to shoulder joint injuries or degenerative and inflammatory conditions. 

Some common conditions that may necessitate shoulder joint replacement include osteoarthritis, rheumatoid arthritis, rotator cuff tears, osteonecrosis (avascular necrosis) and severe shoulder fractures.

The extent of shoulder replacement varies on a case-by-case basis and depends on the extent of damage to the patient’s shoulder. Some of the potential replacement options include the ball (head) of the humerus bone or both the ball and the socket. 

Arthroscopic Shoulder Stabilization 

When a person’s shoulder frequently becomes dislocated or slips out of the joint, they may be diagnosed with an unstable shoulder. Not only is the condition itself painful and uncomfortable, it can also interfere with people’s day-to-day lives, as they may refrain from movements and activities that could result in shoulder dislocations. There’s an additional high risk for damage to ligaments, tendons and muscles due to repeated dislocations. 

Thankfully, minimally invasive arthroscopic surgery is one of the best surgical solutions to stabilize a shoulder. The goal of this outpatient procedure is to reattach and secure torn or loose ligaments to the shoulder joint using specialized anchor sutures. Arthroscopic shoulder stabilization is a relatively fast procedure that results in very minimal scarring thanks to the small incisions that are required.

Rehabilitation will be required after shoulder stabilization surgery, but the length and extent of rehabilitation varies based on the patient and the severity of their subluxation. 

Arthroscopic Rotator Cuff Repair 

The head of the upper arm bone, known as the humerus, is protected by the rotator cuff tendons. The rotator cuff itself are the muscles that surround the ball and socket joint of the shoulder. These muscles and tendons help people throw, move their arms side to side and keep the head of the upper arm bone centered in the shoulder socket, helping prevent dislocations. These tendons and muscles are important for professionals who frequently raise their arms above their head, such as you would when lifting a box, as well as athletes who frequently throw balls or swing rackets. 

A rotator cuff tear occurs when the rotator cuff tendons or muscles are torn or become frayed. This damage can occur in an instant due to trauma or can happen gradually due to repetitive stress or frequent use. This can result in the onset of sudden, acute pain or a gradual buildup of pain, as well as reduced mobility, strength and stability, depending on the type of rotator cuff injury. 

A skilled arthroscopic surgeon, such as Dr. Barbour, can thread the specially designed tools through the small incisions to line up the torn or frayed ends of the muscles and tendons and suture them back together. Patients will be able to go home right after the surgery. 

Healing is fast, and scarring will be minimal thanks to the small incisions. Rehabilitation will be required following rotator cuff repair, but the length of having to wear a sling and the duration of rehabilitation varies depending on the extent of the rotator cuff injuries. 

Shoulder Labrum Reconstruction 

The ring of cartilage that surrounds the shoulder joint socket and helps stabilize the shoulder joint is known as the labrum. The bicep tendon is connected at the labrum, making this cartilage important not only for maintaining a pain-free range of motion but also arm strength and stability. Labral tears can be repetitive stress injuries brought on by sports like baseball or weightlifting. Older athletes may have a higher risk for labrum tears due to the combination of age-related wear and tear and overuse.

These tears are sometimes referred to as Bankart tears and can also contribute to shoulder instability and frequent shoulder re-dislocations. In most cases your doctor will prescribe manipulation, occupational therapy and rest, but in severe cases the labrum may need to be reattached to the shoulder socket. Shoulder labrum reconstruction is another procedure that benefits from the miniaturized instruments used in arthroscopic surgery. 

If you or your primary care physician believe a torn labrum is causing your shoulder pain, shoulder instability or frequent dislocations, you should consult with Dr. Barbour to find out if minimally invasive shoulder labrum reconstruction is a viable treatment alternative for your shoulder labrum injury. 

Shoulder Fracture Treatment 

In many cases, shoulder fractures can be treated without resorting to surgery. Compound fractures where the bone protrudes from the skin or severe fractures where the bones, tendons and muscles of the shoulder are significantly misaligned will likely require surgery to properly place and secure for optimal healing. 

The length and complexity of the surgery depends on the fracture and the misalignment of the bones. 

Types of Shoulder Fractures 

Scapula Fractures – Only about 10 to 20 percent of shoulder blade (scapula) fractures require surgery. It’s usually only necessary if there is fragmentation of the scapula, in which case the fragments must be secured in place to ensure they heal correctly. 

Proximal Humerus Fractures – The proximal humerus is the upper part of the of the arm bone – specifically the head and the part that connects into the shoulder joint. As with other fractures, surgery isn’t usually required unless it is severe, and the bone needs to be manually repositioned. Screws, plates and pins may be necessary to keep the fractured bones in place. 

Clavicle Fractures – The clavicle, frequently referred to as the collarbone, runs between the shoulder blade and the breastbone on both sides of the body. These frequently broken bones are subjected to a significant amount of force on shoulder impacts or when a person catches themselves with outstretched arms to break a fall. Due to the position of the collarbone, the only real non-surgical treatment option are slings to minimize movement. If the break is complex, surgical implantation of rods, screws and plates may be necessary to stabilize the fracture. 
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