Get Relief From Shoulder Pain

The rotator cuff is a group of tendons and muscles that support the shoulder joint and allow for complete movement while keeping the ball of the arm bone in the shoulder socket. These tendons and muscles may become torn or otherwise damaged from injury or overuse and can lead to pain, weakness and inflammation. Surgery may be used to treat this often serious condition.

Rotator cuff repair is performed under general anesthesia and aims to reattach the tendon back to the arm, along with removing any loose fragments from the shoulder area. Most rotator cuff procedures can now be performed through arthroscopy, which uses a few tiny incisions rather than one large incision. This technique offers patients minimal trauma, less scarring and less damage to surrounding tissue. Dr. Lager performs a majority of these rotator cuff repairs arthroscopically, including large and massive type tears.

Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. Patients must undergo physical therapy after surgery, and it may take months for the shoulder to fully heal. Arthroscopic rotator cuff repair is considered much safer than the traditional procedure, requires less dissection, and often causes less pain.

The capsule around the shoulder that encases all of the structures of the joint may become hardened and restricting as a result of prolonged immobilization or other factors. If this occurs, patients may experience pain, stiffness and limited range of motion. Debridement is a surgical procedure that removes damaged or degenerated tissue from the tightened capsule in order to relieve symptoms and restore function to the shoulder.

This procedure can be performed through arthroscopy or through an open procedure, depending on the severity of the condition and the individual health of the patient. Arthroscopy offers patients the advantages of a minimally invasive procedure, while the open procedure allows greater access to the joint. Your surgeon will decide which type of procedure is best for you after a thorough evaluation of your condition.

Total Shoulder Replacement

Severe shoulder conditions with persistent symptoms that have not responded to conservative treatments may benefit from shoulder replacement surgery. Shoulder replacement surgery replaces the damaged joint with an artificial one that allows patients to enjoy painless motion and resume their regular activities.

Shoulder replacement surgery is often performed to treat conditions such as: Osteoarthritis, Rheumatoid Arthritis, Rotator Cuff Tears and Osteonecrosis.

Patients with severe cases of these conditions often experience pain, limited range of motion, stiffness, swelling and more. These symptoms can be effectively relieved by replacing the damaged bone and cartilage with a metal and plastic implant. Similar to the hip, the shoulder is a ball-and-socket joint that can be significantly improved with joint replacement surgery.

Shoulder replacement surgery takes about two hours to perform and is usually done under general anesthesia. It is performed through a traditional open procedure that requires a four to six inch incision.

Patients will be required to stay in the hospital for one to three days and will need physical therapy in order to restore function to the joint after surgery. Most patients are able to return to all of their regular activities after two to three months.

Hemiarthroplasty

Hemiarthroplasty is a surgical procedure that replaces one half of the shoulder joint with a prosthetic while leaving the other half intact. This procedure is performed to treat severe osteoarthritis of the humeral head (considered the “ball” of the joint), while the glenoid (“socket” of the joint) is still in good condition, and for severe fractures of the humeral head.

Surgery is usually considered a last resort treatment for arthritis, as conservative treatments like rest and anti-inflammatory medication are often effective in managing symptoms, especially for younger patients. This procedure is most often performed on patients in the more advanced stages of arthritis.

Once the damaged head of the upper arm has been replaced, patients will notice significant symptom relief, as the bone ends will no longer rub together and cause the painful friction associated with osteoarthritis.

While most clavicle and humerus fractures can be treated without surgery, those that are severe or have moved out of place may require surgery to ensure proper healing. This procedure realigns the bones and secures them into place with the use of surgical hardware that may or may not be removed in the future.

This technique allows for shorter hospital stays, faster recovery times and a lower risk of improper healing often experienced with other treatments. In order to heal properly, a broken bone must be supported in the correct position until it can bear weight on its own. Since some bones cannot do this on their own, additional treatment may be needed, which can be achieved through open reduction internal fixation.

With open reduction internal fixation, your surgeon will make an incision in the area and place the bones in their proper position, securing them with tools such as wires, plates, rods, pins, nails and screws to support the fractured bone while it heals.

The acromioclavicular (AC) joint is the meeting point of the acromion and clavicle bones, often indicated with a visible bump in the area. AC joint injuries often result from a fall or other trauma, which causes the ligaments to be stretched or torn, causing the acromion to separate from the clavicle.

While conservative treatment is often used first for AC joint injuries, surgery may be required for injuries that are more severe or those that cause prolonged pain. Surgery for AC joint injuries may involve removing the end or restoring the position of the clavicle to relieve pain and allow the patient to resume normal functioning of the joint.

These procedures may be performed through arthroscopy or through a traditional open procedure, depending on the type and severity of each patient's individual condition. Arthroscopy offers patients smaller incisions, shorter recovery times and less trauma. Your surgeon will decide which type of procedure is best for you after a thorough evaluation of your condition.

A superior labral anterior-posterior (SLAP) lesion is an injury to the labrum of the shoulder joint, the cuff of cartilage that forms a cup for the arm bone to move within, increasing shoulder stability. Injury to the labrum is often caused by a pulling on the biceps tendon during an overhead throw or from other types of trauma.

Patients with a SLAP lesion may experience pain with movement, limited range of motion, frequent dislocation and a catching sensation in the shoulder. There are several different types of SLAP lesions, each of which may require its own specific treatment.

Some SLAP lesions may only cause mild pain that patients can choose to deal with if they do not want to undergo surgery, as this condition does not usually worsen with time. For those that cause more severe pain, surgery is usually performed, which may include:

Surgery for SLAP lesions is performed on an outpatient basis and takes about 90 minutes. These procedures can usually be performed arthroscopically through several small incisions, into which a camera and tiny surgical instruments are inserted. Physical therapy may be required for six to 12 weeks after surgery to ensure that the joint heals properly.

A Bankart lesion involves a labral tear to the inferior glenohumeral ligament. This injury occurs as a result of a shoulder dislocation, the force of which can often tear the labrum, especially in younger patients.

Successful treatment of some Bankart lesions can be achieved through conservative methods such as rest, immobilization and physical therapy. More severe cases may require surgery to reattach the torn labrum to the socket of the shoulder. This procedure is usually successful for most patients, allowing them to return to regular activities with little to no incidence of recurring dislocation. Surgery to repair a Bankart lesion can often be performed through arthroscopy.

Patients under the age of 30 are more likely to sustain multiple shoulder dislocations after experiencing a Bankart lesion. Correcting the lesion through surgical treatment will significantly reduce this occurrence and allow patients to return to physical activity with a much lower risk of re-dislocation of their shoulder.

After surgery, patients will require immobilization and additional physical therapy before returning to their regular activities.