Dr. Benjamin DuBois specializes in shoulder surgery with particular expertise in shoulder replacement surgery and arthroscopy.
According to the American Orthopaedic Society for Sports Medicine, more than 1.4 million shoulder arthroscopies are performed worldwide each year.
Arthroscopic Shoulder Surgery, or arthroscopy, is a minimally invasive surgical procedure that uses a small camera called an arthroscope. The arthroscope is inserted through a small incision to examine or repair specific areas within or around the shoulder joint.
Shoulder Arthroscopy Procedures
Your shoulder is the most flexible joint in your body allowing you to place and rotate your arm in many positions in front, above, to the side, and behind your body. This flexibility also makes your shoulder susceptible to instability and injury.
Shoulder Joint Examnation
One of the uses for shoulder arthroscopy is to inspect the shoulder joint and surrounding areas to confirm a diagnosis and determine the extent of injury of disease process. Your surgeon will determine if the minimally invasive procedure can be used for a surgical repair instead of a traditional open surgical procedure.
Shoulder Joint Surgery
Often when using shoulder arthroscopy to make or confirm a diagnosis, surgery is performed to correct conditions affecting muscles, cartilage, joints or ligaments in the shoulder damaged as a result of injury, disease or aging. By performing the surgery during the arthroscopic examination, the surgeon is able to perform a repair without having to inconvenience the patient with a second procedure. By doing so, this eliminates the need for a large incision minimizing blood loss and discomfort helping to speed recovery.
Conditions treated using Shoulder Arthroscopy
Depending on the complexity of the repairs that need to be made, shoulder arthroscopy may be used to correct the following conditions:
Cartilage or ligaments that have been torn or damaged
- Shoulders with instability where a shoulder joint is loose and/or the shoulder dislocates and slips out of the ball and socket joint becoming dislocated
- Biceps tendon that is torn or damaged
- Torn rotator cuff
- Bone spurs or inflammation around the rotator cuff
- Joint inflammation or damage caused by an illness such as arthritis
- Loose tissue that interferes with movement and has to be removed
- Shoulder impingement where movement is impaired
Most arthroscopic shoulder surgery is performed as an outpatient procedure under general anesthesia, eliminating the need for a hospital stay.
Today, about 53,000 people in the U.S. have shoulder replacement surgery each year, according to the Agency or Healthcare Research and Quality.
If nonsurgical treatments like medications and activity changes are no longer helpful for relieving pain, you may want to consider shoulder joint replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain and help you resume everyday activities.
Shoulder Replacement Surgery
Total shoulder replacement, also known as total shoulder arthroplasty (TSA), is a tremendously successful procedure for treating the severe pain and stiffness that often results at the end stage of various forms of arthritis or degenerative joint disease of the shoulder joint.
When shoulder replacement surgery is performed, the ball is removed from the top of the humerus and replaced with a metal implant. This is shaped like a half-moon and attached to a stem inserted down the center of the arm bone. The socket portion of the joint is shaved clean an replaced with a plastic socket that is cemented into the scapula.
The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket. If only 2 of these 2 bones needs to be replaced, the surgery is called a partial shoulder replacement, or a hemiarthroplasty.
Once set in place, the patient's new shoulder joint should allow for a wider range of motion with less pain.
Reverse Shoulder Replacement
For some patients, shoulder arthritis coupled with a severely torn rotator cuff, known as "cuff tear arthropathy," rules out traditional shoulder replacement as an effective treatment option. The shoulder replacement procedure outlined above, in which the ball and socket components are replaced with new prosthetic components, may result in pain and limited mobility after surgery for these patients. A different type of shoulder replacement, called reverse shoulder replacement, may be available for many of these patients and provide pain relief as well as a stable functioning shoulder.
Reverse shoulder replacement has the ball of the shoulder joint where the socket should be and the socket where the ball usually is in normal anatomy. Thus the anatomy is reversed. This may seem very strange, but this arrangement has some unique mechanical advantages for people who have lost the normal mechanics of their shoulder with massive rotator cuff tears with arthritis. Reverse shoulder replacement relies on different muscles to move the arm, and so it tends to be a better option for these patients. Because traditional shoulder replacement components rely on the rotator cuff muscles, these patients will typically experience pain whenever trying to use these muscles.
Just like any joint replacement the success of the surgery depends on many factors including the advanced state of the arthritic joint at the time of surgery, the overall health of the patient and the dedication to the physical therapy required after the surgery.