Shoulder pain is a very common complaint, affecting patients of all ages. Gradual ‘wear and tear’ of soft tissue, or an acute injury of bones and ligaments within the joint can cause chronic pain. Shoulder pain can often be quite debilitating, interfering with all aspects of daily living. Locating the primary cause of the pain determines the type of treatment necessary to effectively eliminate the pain, and restore function and mobility to the shoulder.
Rotator Cuff Tear
What is the rotator cuff?
The rotator cuff is made up of four small muscles and tendons that help rotate and stabilize the shoulder joint. Collectively they are used to perform overhead motions such as lifting our arms to comb our hair, dressing ourselves, or reaching for an item on a top grocery shelf. The most commonly involved rotator cuff tendon is the supraspinatus. The other three tendons are subscapularis, infraspinatus and teres minor.
The shoulder joint is a ball-and-socket joint – the ball being the humeral head and the socket the glenoid. The functions of the individual rotator cuff tendons vary depending on where they attach to the humeral head. The supraspinatus tendon attaches to the top of the humeral head.
Shoulder impingement is the condition of inflammation of the tendons of the shoulder joint. It is one of the most common causes of pain in the adult shoulder. The shoulder is a ‘ball-and-socket’ joint. A ‘ball’ at the top of the upper arm bone, humerus, fits neatly into a ‘socket’, called the glenoid, which is part of the shoulder blade, scapula. Shoulder impingement is also called as swimmer’s shoulder, tennis shoulder, or rotator cuff tendinitis.
Impingement results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. It is more likely to occur in young and middle aged people who engage in physical activities that require repeated overhead arm movements.
Reconstructive Shoulder Surgery
Shoulder instability is a problem of loose shoulder joint that occurs when the structures that surround the shoulder joint such as the ligaments, capsule and cartilage become overstretched or injured. When this occurs you may have shoulder joint dislocation. A dislocation occurs when the head of the upper arm bone (humerus) is forced out of the shoulder socket (glenoid).
Arthroscopic Latarjet Procedure
What is the Latarjet procedure?
The Latarjet procedure was developed over 50 years ago by French surgeons to treat shoulder instability. It involves using a bone graft from the shoulder blade (coracoid) and attaching it to the front of the shoulder joint (glenoid) with the help of 2 screws.
The arthroscopic Latarjet procedure is the same procedure but performed through key-hole incisions using very specialised instruments.
The Latarjet is a very effective and robust method to prevent further shoulder dislocations. It works by two main ways.
Total Shoulder Replacement
Shoulder joint replacement is a surgical procedure performed to replace the damaged shoulder joint with the artificial joint parts. Shoulder joint replacement is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, rotator cuff tear arthropathy, avascular necrosis and failed former shoulder replacement surgery.
During the surgery an incision is made over the affected shoulder to expose the shoulder joint. The humerus is separated from the glenoid socket of the scapula. The arthritic part of the humeral head and the socket is removed and prepared so as to take the artificial components.