Shoulder surgery

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Definition

Shoulder surgery has been a recognised surgical discipline within orthopaedic surgery and traumatology since the late ’90s.

This expansion is linked to four factors:

  • Improvements in diagnostic medical imaging (MRI and MRI arthrogram) 
  • Development of minimally-invasive, arthroscopic surgery 
  • Reliability of shoulder prostheses
  • Effectiveness of rehabilitation protocols

The most common shoulder conditions are: 

  • Injuries to the rotator cuff tendons (the rotator cuff acts like the shoulder’s “engine”)
  • Ankylosis or stiffness of the shoulder, also known as adhesive capsulitis or frozen shoulder 
  • Osteoarthritis of the shoulder, which can be central or eccentric
  • Sporting injuries, including shoulder dislocations, acromioclavicular joint disorders, clavicle fractures and greater tuberosity fractures.

 

Conditions involving the rotator cuff tendons

Conditions involving the rotator cuff tendons are linked to wear and tear caused by frequent and prolonged activities where your arms are raised above your head. Bone spurs located on the acromion, which may have been present at birth, can make your condition worse. 
Wear can lead to a tear in one or more of the tendons, most often in patients over the age of 50.

Rotator cuff surgery is currently performed using minimally invasive arthroscopic surgery. It provides excellent results in terms of shoulder function as long as surgery and post-surgery rehabilitation is delivered by a multidisciplinary medical team who specialise in shoulders. 

Ankylosis of the shoulder

In most cases, ankylosis of the shoulder or adhesive capsulitis requires specialised physiotherapy sessions, where the patient must also do stretching exercises at home several times a day. 
Recovery times are much shorter when physiotherapy is delivered by a specialist physiotherapist for a motivated patient. 

 

Osteoarthritis of the shoulder 

Osteoarthritis of the shoulder is often treated by shoulder replacement surgery as this gives excellent long-term results for shoulder function. 

Different prosthetic implants are fitted depending on the medical condition:

  • If the rotator cuff is healthy and intact, a sliding “anatomic” shoulder prosthesis is used 
  • If the rotator cuff has worn away, a “reverse” shoulder prosthesis is used.

In both cases, arthroscopic shoulder replacement surgery must be performed by a skilled surgeon, who has extensive experience in performing this type of surgery, and who works with physiotherapists who also have experience in treating patients with shoulder replacements.

 

Sport injuries

Sports injuries are more common in certain sports, for instance skiing, rugby, motorcycling, cycling and mountain biking. 

  • Our doctors treat these injuries, which can include clavicle fractures, acromioclavicular joint dislocation and greater tuberosity fractures, using an orthopaedic treatment approach. 
  • In some cases, complex proximal humeral fractures require osteosynthesis, a surgical procedure that uses internal fixation devices.
  • Anterior shoulder dislocations are the most common type of shoulder dislocation and require stabilisation surgery, using an arthroscopic approach or traditional open surgery, in order to prevent the shoulder from dislocating again. 

 

Summary

80% of shoulder surgery is now performed using the popular technique of arthroscopy as it usually results in less pain and reduces the risk of infection after surgery.
Traditional open surgery is used for shoulder replacement surgery and for treating recurrent shoulder dislocations. 
The quality of the physiotherapy plays a key role in a patient’s recovery and is responsible for 50% of the outcome.
Your shoulder condition must always be treated by a specialist, multidisciplinary team made up of surgeons, radiologists, physiotherapists and orthopaedists.

 

If you have any further questions, we’re here to help, so please get in touch.