The shoulder has the greatest range of motion of any joint in the body. To achieve such incredible motion, the bony joint itself is inherently unstable. It achieves stability by several factors that are all essentially soft tissue in nature.
Because of the shoulder's range of motion and tendency for inherent instability, there is notable stress and force that goes across these soft tissues, increasing the opportunity for injury and degeneration. Shoulder pain and injuries are common, especially among people who play sports that require overhead arm movements or perform job duties with repetitive motions.
With fellowship training in shoulder surgery, upper extremity surgery, and sports medicine, the orthopedic surgeons at OrthoKnox have earned the highest credentials as shoulder surgeons, and they have great skill in treating the many injuries and conditions of the shoulder with techniques including:
Arthroscopic Rotator Cuff Repair
Rotator cuff tears can occur from a single traumatic event or as a result of degenerative changes and the culmination of smaller traumas to the tissue. The risk of rotator cuff damage increases with age, as the shoulder tendons and muscles may show signs of degeneration.
Arthroscopic rotator cuff surgery is a minimally invasive approach performed through small 5 mm incisions to sew and repair the torn rotator cuff down to the bone. Typically, small anchors that fixate in the bone with a variety of designs are used to anchor the suture so that it can hold the tendon to the bone.
While surgery may be successful in pulling the tear back to its native position, only time and appropriate therapy will achieve the actual healing desired. Hence, the correct post-operative therapy regimen is crucial to getting a good result.
Arthroscopic Bankart Reconstruction
When the shoulder has a traumatic dislocation, part of the stabilizing structures of the shoulder – the capsule and labrum – are torn, and the shoulder is at risk for recurrent episodes of instability. Each time the shoulder slides out of socket it is at least a painful and disabling event, and at worst doing more traumatic damage to the articular structures of the shoulder.
Arthroscopic Bankart reconstruction is a technique used to repair the torn capsule and labrum, thereby restoring shoulder stability. Arthroscopic Bankart reconstruction reattaches the labrum and tightens ligaments. Typically, this is achieved by means of small suture anchors that fixate in the bone with the suture attached in such a way to allow sewing the ligaments and labrum back to the bone. Once again, the appropriate post-operative therapy regimen is crucial to achieving good long term outcomes.
Arthroscopic Subacromial Decompression for Shoulder Impingement
Shoulder impingement syndrome is a painful condition that occurs when the tendons in the shoulder are irritated, inflamed, or degenerated from repetitive overhead motions or structural abnormalities in the shoulder. Classically, there is a prominent area of bone on the front of the acromion of the shoulder that impinges on the rotator cuff, thereby giving the name “impingement syndrome.” In layman’s terms, we will often refer to this area of bony prominence as a “bone spur.” With arthroscopic subacromial decompression, the impingement is relieved by shaving off the bony prominence and debriding the inflamed, irritated bursa. Symptoms of pain are relieved and more normal function is restored.
Arthroscopic Treatment of Shoulder Arthritis
Arthritis is a common disease that causes joint pain, stiffness, immobility, and swelling. Arthritis is a degeneration of the articular cartilage, followed by a flaking away or loss of the cartilage, and finally, exposed bony surfaces in the joint. As the cartilage wears away, other changes occur as well, such as tightening of the joint capsule. Arthroscopic shoulder surgery is used to relieve pain and restore functional movement by cutting tight capsular tissue and allowing more movement.