Type of Surgery

Types of Shoulder Surgery

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Last updated: 09/08/2009

Types of Shoulder Surgery
Our shoulder is one of the most amazing joints in our body, with a full 360 degree range of motion at close to full extension. The rotator cuff is actually a collection of four muscles in the shoulder that are used to achieve this wide range of movement. However amazing, though, our shoulder is not invincible - some of the most common orthopedic surgeries performed are shoulder arthroscopy and open surgical rotator cuff treatment. Here we look at the two types of shoulder surgery, and what your physician is most likely to recommend based on your history and injury type.
Arthroscopy is a minimally invasive type of shoulder surgery, and is suitable for some rotator cuff repairs. Surgeons will make small incision and use the natural cavities in your body to get to the injured area without cutting open your entire shoulder. The portals that are used to perform arthroscopy are around 10 cm (4 in) long, and located over the particular areas that surgeons need to work on.
A video camera with a fiber optic light will be inserted into your body. Sometimes only a local anesthetic is needed, but some patients will need a general anesthetic. The instruments that surgeons use in this type of shoulder surgery are able to repair tears and damaged tendons, attach stitches, and remove (debride) inflamed tissue.
Rotator Cuff Repairs - Open Surgery
In rare cases it may be necessary to repair the rotator cuff with open surgery. Whether an open surgical procedure is required will be determined by your consulting physician. As a general rule, open surgery is a last resort for shoulders that continually tear or are unresponsive to treatment.
While open shoulder surgery sounds dramatic, it can sometimes provide better results than arthroscopic shoulder surgery. The incisions are not generally much larger than for arthroscopic procedures, and the physical therapy required is usually the same as when the same type of surgery is performed arthroscopically.
Shoulder replacement
A total shoulder replacement is a complex type of shoulder surgery, but for some conditions is the only option. If you have developed avascular necrosis, or have had a fracture that has led to lowered blood flow in the area, a total shoulder replacement may eventually be needed. Arthrosis, a deterioration of the bone, and rheumatism, a deterioration of the cartilage, also require total shoulder replacements.
In total shoulder replacement surgery, a plastic and metal ball/socket joint is put in place of your natural shoulder. The socket portion of the transplant is cemented, while the ball portion is screwed into the center of the arm bone.
Older patients who have degenerating bone density are often advised against having total shoulder replacements. The insertion of the ball portion of the transplant can be risky when the bone is already naturally weakened. Your doctor may ask you to prepare for this type of shoulder surgery with calcium supplementation and medium-impact exercise.
No matter what type of shoulder surgery you have, your doctor will create an exercise plan for you to help ensure good muscle healing, strength and range of movement in the joint. The post-operative weeks are the most important, as the muscles are recovering.

Last Updated: 09/08/2009

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