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Shoulder Surgery
The shoulder is a ball and socket joint made up of a large ball (humerus) and a shallow socket (glenoid). It is prone to injury from overhead work or play, as well as age related wear and tear. Symptoms of a shoulder problem may include pain, weakness, or instability.
Our shoulder specialists at The Orthopaedic Group can guide you through the investigation and management of shoulder problems, and provide advice on both operative and non-operative strategies for care.
Conditions
Shoulder Arthritis
Shoulder Arthritis
Arthritis describes a loss of cartilage from a joint resulting in pain and stiffness that can be slowly progressive. Patients find that they cannot reach behind their back or overhead due to pain. Occasionally the pain can be quickly progressive if the arthritis is severe.
Glenohumeral (shoulder) arthritis may result from prior injury (such as fractures or dislocations), inflammatory conditions (Rheumatoid arthritis) or age related wear.
Chronic rotator cuff tears may also result in the development of shoulder arthritis.
Shoulder Joint Dislocations
Shoulder Joint Dislocations
Shoulder dislocations are a common injury which can result in ongoing problems including pain, weakness, loss of trust in the shoulder, or recurrent instability episodes.
Shoulder dislocations can cause injury to the glenoid labrum (the attachment of the lining of the shoulder to the socket), the bone, and the rotator cuff tendons. With repeated episodes, further injury can occur to the shoulder cartilage increasing the risk of subsequent arthritis.
Rotator Cuff Conditions
Rotator Cuff Conditions
The “rotator cuff” are a group of small muscles that hold the ball of the shoulder in place against the glenoid socket. They function to initiate movement and keep the shoulder elongated during motion, allowing the larger shoulder muscles to work more efficiently.
Conditions affecting the rotator cuff include inflammation (tendonitis), partial thickness tendon tears, and full thickness tendon tears. Tears may occur in overhead athletes, following trauma, or may be age related.
Problems of the rotator cuff can cause pain with movement, affecting daily activities such as reaching overhead, driving and sleep. Larger tears, involving more of the rotator cuff muscles, may cause weakness and restrict shoulder motion.
Acromioclavicular Joint Conditions
Acromioclavicular Joint Conditions
The acromioclavicular joint (or AC Joint) is the connection of your collar bone to the shoulder blade. This small joint transmits all the force from your arm to your trunk. Arthritis in the joint may occur as a consequence of activity and age, and cause pain around the shoulder.
Pain is typically felt over the joint itself and may radiate to the tip of the shoulder or the base of the neck. Symptoms may be provoked by lying on the affected side or using the arm overhead.
The AC joint may also be injured acutely by falls causing dislocation. This results in acute pain and an abnormal appearance of shoulder where the collar bone is typically prominent.
Frozen Shoulder
Frozen Shoulder
Also known as Adhesive Capsulitis, this condition is the result of inflammation of the lining of the shoulder joint, causing discomfort and pain. There is a progressive loss of range of motion, during which time the pain may be reduced.
Typically there is no clear cause although the onset may follow minor shoulder injuries, including surgery.
Symptoms typically resolve without surgical treatment over an 18 month period. During this time the shoulder can be very uncomfortable, disturbing daily activities and sleep.
This condition can be worse in individuals with diabetes and can also occur in the opposite shoulder at a later date.
Shoulder Procedures
- Shoulder Arthroscopic Surgery
Arthroscopy describes the use of a camera and specialist tools to work inside a joint. This is done through small “key-hole” incisions in the skin and around the shoulder can be used to remove loose bodies, treat infection or manage imgingement or instability. Common arthroscopic procedures that often take place together include:
Rotator Cuff or Labrum repair involves reattaching the torn tissue to the bone, using “anchors” or sutures. In cases of larger or more complex tears, a tissue graft (tissue taken from one site and implanted into another) may be needed.
Shoulder Stabilisation tightens tissue around the shoulder, which is often lax following recurrent dislocation, or interposes tissue to fill a bony defect.
Decompression Procedures for Impingement removes excess bone or spurs from the underside of the shoulder blade (acromion) to prevent rubbing or catching of tissue (sub acromial bursa or rotator cuff muscles).
Open Shoulder Stabilisations (Latarjet) uses a block of bone and tendon transposed from the shoulder blade (coracoid process) to the front of the socket (glenoid) to provide a restraint against anterior dislocation. This is often the appropriate choice for younger patients with instability or those involved in overhead throwing or collision sports.
- Acromioclavicular Joint Surgery
Arthritis or instability in the AC joint may be treated with open or arthroscopic excision of the joint. More complex ligament reconstruction or stabilisation procedues are sometimes appropriate depending on patient age and functional demands.
- Shoulder Arthroplasty (Joint Replacement)
Shoulder replacement surgery removes the damaged joint and replaces it with an artificial bearing that relieves pain and preserves movement. It may be an “anatomic total shoulder replacement” designed to replicate the normal motion of the shoulder, or a “reverse total shoulder replacement’ which reverses the positions of the ball and socket to increase the strength of pull of muscles in a patient with a deficient rotator cuff.
Shoulder Surgery Specialists
Jonathan Spencer
Bachelor of Science in Anatomy (Honours)
Bachelor of Medicine and Bachelor of Surgery
Fellowship of the Royal College of Surgeons (England)
Fellowship of Royal College of Surgeons (Trauma and Orthopaedics) (England)
Fellowship of the Royal Australian College of Surgeons (Orthopaedics)
Fellow of the Australian Orthopaedic Association
- Shoulder Surgery
- Elbow Surgery
- Knee Surgery
