Arthroscopic Bankart Repair
This arthroscopic procedure is used to repair a detached labrum. The labrum is a thick bank of cartilage attached to the glendoid bone. It lines the shoulder socket and helps keep the ball of the humerus in place.
To begin this procedure, small incisions are made in the front and back of the shoulder. The surgeon inserts a small video camera, called an arthroscope, to view inside the joint. Small instruments are inserted to perform the procedure.
When finished, the surgeon cleans the area around the detached labrum, removing any loose particles or rough edges. The anchors are then placed by drilling a few small holes in the bone near the detached labrum. Once the anchors are placed in the holes, they are used to hold statures in place around the glendoid.
The surgeon attaches the structures to the labrum and pulls the sutures tightly against the anchors, reattaching the labrum to the glendoid. The incisions can be closed with small bandages. After surgery, the arm is usually placed in a sling. Physical therapy will be needed to regain full range of motion and increased shoulder strength. Over time, the labrum will naturally reattach itself to the glendoid socket.
Arthroscopic Rotator Cuff Repair
This surgical procedure is used to inspect and reattach torn tendons in the shoulder’s rotator cuff. The initial part of the surgery is performed arthroscopically though small tubes. In some cases, open surgery may be needed to repair large tears.
The surgeon inserts a small video camera called an arthroscope though tiny incisions in the shoulder to inspect the damaged joint. The surgeon removes any loose fragments of the tendons or other debris from the damaged cuff tendon in the joint. This procedure, called debridement, is usually performed arthroscopically.
Afterwards, the surgeon inspects the tissue damaged in the joint and determines if more surgery is needed. If bone spurs have formed in the bottom of the acromion, the surgeon uses a rasp-like tool to smooth the area. This is called subacromial decompression, or smoothing, and will keep the acromion from pinching down on the supraspinatus tendon. It is usually done arthroscpically.
If no tear is found in the rotator cuff area, the procedure may end here. If the surgeon finds a torn rotator cuff tendon, the type of repair needed is based on the size and severity of the tear. Small to moderate tears may be repaired arthroscopically. Open surgery may be needed to repair large tears. First, the torn end of the tendon is cleaned up. Next, an area on the humerus is cleared.
The surgeon uses a drill or sharp tool to create one or more holes in the bone. Anchors are then placed into the holes to hold stitches in place on the arm bone. The tear in the tendon is stitched together, and the sutures are pulled tightly against the anchors, reattaching the tendon to the humerus.
After surgery, the arm is usually placed in a sling. Physical therapy will be needed to regain full range of motion and increased shoulder strength. Over time, the tendon will naturally attach itself to the humerus bone.
This minimally invasive surgical procedure is used to repair a rupture or partial tear of the biceps tendon in the shoulder, or to treat chronicle tendonitis. In this procedure, the long Head of Biceps (LHB) tendon is reattached to the top of the humerus, relieving pain, discomfort, and restoring stability and strength to the arm.
Preparation for this procedure begins by positioning the patient so that the front of the shoulder is clearly visible to the surgeon. Next, the area is cleaned and sterilized. Local anesthesia is administered to numb the injection site and a sedative is provided to relax the patient. General anesthesia may sometimes be used.
The surgeon creates two small incisions on the shoulder and inserts an arthroscopic camera and arthroscopic scissors. The camera allows the surgeon to view the procedure on a monitor. Arthroscopic scissors are used to remove the damaged portion of the LHB tendon at the scapula. A small incision is made in the front of the shoulder and the top of the tendon is retrieved through the hole. Any damaged portions of the tendon are removed.
The tendon is placed back into the shoulder joint and the top is positioned over the top of the humerus. A small hole is drilled into the humerus and the end of the LHB tendon is placed into the hole. A surgical fixation screw is inserted into the hole over the tendon to hold the tendon in place.
The incisions are closed with sutures or surgical staple, the shoulder is bandaged, and the patient is given pain relievers. Patients should be able leave the hospital within a day, but physical therapy will be required 1-2 weeks after the surgery.
Shoulder Impingement Surgery
This outpatient procedure relieves pain be decompressing the tight space around the rotator tendon of the shoulder joint. The surgeon removes the bursa and trims back the acromion bone to allow for normal pain-free motion. In most cases, this procedure is performed arthroscopically.
The surgeon creates three small incisions in the shoulder to access the joint. A thin metal tube is inserted in one incision. Fluid is pumped through the tube and into the joint. This expands the joint, giving the surgeon a clear view and room to work.
An arthroscope, which contains a light and small video camera, is inserted into another incision to give the surgeon a clear view of the joint and the hooked acromion. With the video images from the arthrocope as a guide, the surgeon inserts surgical instruments though the third incision.
The swollen bursa tissue is removed. Another surgical tool is inserted to cut away the impinging coracoacomial ligament. The hooked portion of the acromion bone is shaved away, opening up the space above the supraspinatus tendon.
After the joint is drained and the instruments are removed, the incisions are closed using stitches or tape. The shoulder is bandaged, and within a few days, physical therapy will begin to help restore the shoulder to its full function.
Total Shoulder Replacement
This surgery replaces the damaged or diseased head of the humerus (also known as the ball) and cartilage from the shoulder joint with a metal and plastic joint.
First, the surgeon removes the head of the humerus. The surgeon then smoothes and reshapes the shoulder socket, which is called the glenoid.
The plastic glenoid component is pressed into place with bone cement. The surgeon hollows out the upper portion of the humerus to receive the implant.
The metal stem is implanted in the humerus, and can be secured with bone cement. The metal ball is placed onto the stem. The surgeon joins the repaired humerus and glenoid components to form the new shoulder joint.