There are many shoulder diseases causing pain, discomfort or inability to move the shoulder properly and thus causing discomfort in day to day activities. Patients will be suffering for many years due to the lack of proper knowledge of shoulder problems and their inability to visit a specialized shoulder clinic. Shoulder joint is a ball and socket type of joint similar to the hip joint. Humeral head forms the ball and glenoid forms the socket. The joint is covered by a thin layer called capsule and group of muscles called rotator cuff. The rotator cuff muscles pass under a bony arch called acromion. These muscles are important for the smooth movements of the shoulder. Disease process can affect any of the above structures.
A commonly heard problem among shoulder patients. It is due to inflammation and contracture of the capsule portion of the joint. Patient experiences pain and stiffness of the joint. It commonly affects older people and especially diabetics. This condition can be treated with good physiotherapy done under the supervision of a shoulder surgeon and shoulder physiotherapist. In severe cases this problem can be treated with advanced key-hole surgery arthroscopic surgery.
In some patients the ball (humeral head) comes out of the socket (glenoid), a condition called dislocation. It is associated with severe pain and inability to move the shoulder. It may happen due to injury to the shoulder during falls, road traffic accidents or while playing sports. This condition commonly affects younger people and these patients stop all sporting activities and other high demand jobs as they develop a fear of repeated dislocations. In many of these patients this condition can successfully be treated with key-hole (arthroscopic) surgery.
Arthroscopic surgery is one of the most standard orthopaedic procedures performed today. An orthoapaedic surgeon can visualize, diagnose, and treat problems within the joints, through the use of small instruments and cameras.
The joints are viewed by making one or more incisions around it. An instrument called Arthroscope is inserted into the joint by the surgeon. The Arthroscope allows the surgeon to view the joint on television, monitor and diagnose the problem, determine the extent of injury and make necessary repairs. It contains a fiber optic light source and a small television that helps the surgeon in doing that. To help view or repair the tissues inside the joint other instruments may also be used.
Shoulder surgery for Rotator Cuff problems generally involves one or more of the following procedures: Debridement, Subacromial Decompression, and Rotator Cuff Repair.
Debridement clears the tissues which are damaged out of the shoulder joint. Subacromial decompression includes shaving bone or getting rid of spurs below the tip of the shoulder blade (acromion). This enhances the space between the end of the shoulder blade and the bone of the upper arm so that the rotator cuff tendon is not tweaked and can smoothly glide. If the Rotator Cuff Tendon is torn, it is stitched together and attached again to the top of the upper arm bone.