Shoulder surgery is a means of treating injured

shoulder The human shoulder is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder mak ...

s. Many surgeries have been developed to repair the muscles, connective tissue, or damaged joints that can arise from traumatic or overuse injuries to the shoulder.

Dislocated shoulder

dislocated A joint dislocation, also called luxation, occurs when there is an abnormal separation in the joint, where two or more bones meet.Dislocations. Lucile Packard Children’s Hospital at Stanford. Retrieved 3 March 2013 A partial dislocation is refe ...

shoulder can be treated with: *

Arthroscopic Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the jo ...

repairs * repair of the

Glenoid labrum The glenoid labrum (glenoid ligament) is a fibrocartilaginous structure (not a fibrocartilage as previously thought) rim attached around the margin of the glenoid cavity in the shoulder blade. The shoulder joint is considered a ball and socket ...

(anterior or posterior) In some cases, arthroscopic surgery is not enough to fix the injured shoulder. When the shoulder dislocates too many times and is worn down, the ball and socket are not lined up correctly. The socket is worn down and the ball will never sit in it the same. After many dislocations the shoulder bones will begin to wear down and chip away. When this occurs, another operation must be done.
Coracoid process of left scapula - animation01

Coracoid process of left scapula - animation01

The operation is called the Latarjet surgery. The procedure involves transfer of the coracoid with its attached muscles to the deficient area over the front of the

glenoid The glenoid fossa of the scapula or the glenoid cavity is a bone part of the shoulder. The word ''glenoid'' is pronounced or (both are common) and is from el, gléne, "socket", reflecting the shoulder joint's ball-and-socket form. It is a sha ...

. This replaces the missing bone and the transferred muscle also acts as an additional muscular strut preventing further dislocations. It is an open surgery and requires overnight hospital stay. Usually a 4-6 month recovery. * Rehabilitation: The recovery depends upon many factors * where the tear was located * how severe it was * how good the surgical repair was It is believed that it takes at least four to six weeks for the labrum to re-attach itself to the scapula bone (shoulder blade), and probably another four to six weeks to get strong. The labrum is a ring of cartilage on the rim of a shallow socket in the scapula into which the head of the upper arm bone normally fits and rotates. Once the labrum has healed to the rim of the shoulder blade, it should see stress very gradually so that it can gather strength. It is important not to re-injure it while it is healing. How much motion and strengthening of the arm is allowed after surgery also depends upon many factors, and it is up to the surgeon to let you know your limitations and how fast to progress. Because of the variability in the injury and the type of repair done, it is difficult to predict how soon someone can to return to activities and to sports after the repair. The type of sport also is important, since contact sports have a greater chance of injuring the labrum repair. However, a vast majority of patients have full function of the shoulder after labrum repair, and most patients can return to their previous level of sports with no or few restrictions. [] * repair of the capsular ligaments (Bankart repair) * repair of the Biceps brachii muscle, biceps long head anchor or SLAP tear, SLAP lesion * tightening of the shoulder capsule (capsulorrhaphy or capsular shift) * Open Repairs (for dislocations with fractures, etc.) * Biceps Tenodesis Surgery Surgical treatment of the shoulder due to potential biceps tendonitis or a tear of the labrum otherwise known as a SLAP tear. The long head of the biceps passes through the shoulder joint and attaches to the labrum. During a biceps tenodesis procedure, the surgeon cuts the attachment of the biceps tendon from the labrum and reattaches it to the humerus bone by tacks. By doing this, pressure is relieved from the labrum significantly reducing pain. This surgery is performed to alleviate biceps inflammation and can be implemented in correspondence to a SLAP lesion surgery. Recovery is approximately 4 – 8 months depending on the individual and requires physical therapy.

Separated shoulder

separated shoulder A separated shoulder, also known as acromioclavicular joint injury, is a common injury to the acromioclavicular joint. The AC joint is located at the outer end of the clavicle where it attaches to the acromion of the scapula. Symptoms include no ...

can be treated with: * Weaver-Dunn procedure * Weaver-Dunn with various additional fixations ( sutures, suture anchors, tendon

autograft Autotransplantation is the transplantation of organs, tissues, or even particular proteins from one part of the body to another in the same person ('' auto-'' meaning "self" in Greek). The autologous tissue (also called autogenous, autogene ...

) to replace the

coracoclavicular ligament The coracoclavicular ligament is a ligament of the shoulder. It connects the clavicle to the coracoid process of the scapula. Structure The coracoclavicular ligament connects the clavicle to the coracoid process of the scapula. It it is not par ...

s. Note: various methods have been utilized to anchor the clavicle in place while the surgery heals. This includes ** Dacron graft/loop ** Bosworth screw ** Kirschner wires ** Hook plate * Anatomic Repair, or any repair using tendon

allograft Allotransplant (''allo-'' meaning "other" in Greek) is the transplantation of cells, tissues, or organs to a recipient from a genetically non-identical donor of the same species. The transplant is called an allograft, allogeneic transplant, o ...

without sacrificing the

coracoacromial ligament The coracoacromial ligament is a strong triangular ligament between the coracoid process and the acromion. It protects the head of the humerus. Its acromial attachment may be repositioned to the clavicle during reconstructive surgery of the acrom ...

. * Arthroscopic Weaver-Dunn * Transfer of conjoined tendon and distal end of

coracoid process The coracoid process (from Greek κόραξ, raven) is a small hook-like structure on the lateral edge of the superior anterior portion of the scapula (hence: coracoid, or "like a raven's beak"). Pointing laterally forward, it, together with the ...

to the clavicle

Sternoclavicular separation

Sternoclavicular separation The sternoclavicular joint or sternoclavicular articulation is a synovial saddle joint between the manubrium of the sternum, and the clavicle, as well as the first rib. The joint possesses a joint capsule, and an articular disk, and is reinfor ...

can be treated.

Tendinitis, bursitis, and impingement syndrome

The

rotator cuff The rotator cuff is a group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are the supraspi ...

can cause pain in many different ways including tendonitis, bursitis, calcific tendonitis, partial thickness tears, full thickness tears or mechanical impingement.

Tendinitis Tendinopathy, a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder (rotator cuff tendinitis, biceps tendinitis), elbow (tennis elb ...

bursitis Bursitis is the inflammation of one or more bursae (fluid filled sacs) of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. There are more than 150 bursae in the human body. The bursa ...

, and

impingement syndrome Shoulder impingement syndrome is a syndrome involving tendonitis (inflammation of tendons) of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion. It is particularly associated with tendonitis of t ...

can be treated with

tendon repair A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...

and the

Mumford procedure The Mumford procedure, also known as distal clavicle excision or distal clavicle resection, is an orthopedic procedure performed to ameliorate shoulder pain and discomfort by excising the distal (lateral) end of the clavicle. Those suffering from ...

acromioplasty Acromioplasty is an arthroscopic surgical procedure of the acromion. Generally, it implies removal of a small piece of the surface of the bone (acromion In human anatomy, the acromion (from Greek: ''akros'', "highest", ''ōmos'', "shoulder", pl ...

Rotator cuff tear

rotator cuff tear A rotator cuff tear is an injury where one or more of the tendons or muscles of the rotator cuff of the shoulder get torn. Symptoms may include shoulder pain, which is often worse with movement, limited range of motion, or weakness. This may limi ...

can be treated with arthroscopic rotator cuff repair.

Fracture

A shoulder fracture can be treated with

open reduction internal fixation Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the m ...

(ORIF).

Arthritis of the shoulder (glenohumeral joint)

Arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...

of the shoulder can be treated with total

shoulder replacement Shoulder replacement is a surgical procedure in which all or part of the glenohumeral joint is replaced by a prosthetic implant. Such joint replacement surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage. ...

hemiarthroplasty Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement or ...

(half a replacement), or a reverse shoulder implant (for arthritis with large rotator cuff tear).

Arthritis or osteolysis of the acromioclavicular joint

Arthritis or osteolysis of the acromioclavicular joint can be treated with the

(open or arthroscopic).

Scapular Winging

Scapular winging due to

serratus anterior muscle The serratus anterior is a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula. The serratus anterior acts to pull the scapula fo ...

(

long thoracic nerve The long thoracic nerve (external respiratory nerve of Bell; posterior thoracic nerve) innervates the serratus anterior muscle. Structure The long thoracic nerve arises from the anterior rami of the C5, C6, and C7 cervical spinal nerve. Th ...

) palsy can be treated with a pectoralis major transfer. Scapular winging due to

trapezius muscle The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves the scapula and supports the ...

(

spinal accessory nerve The accessory nerve, also known as the eleventh cranial nerve, cranial nerve XI, or simply CN XI, is a cranial nerve that supplies the sternocleidomastoid and trapezius muscles. It is classified as the eleventh of twelve pairs of cranial nerves ...

) palsy can be treated with an

Eden-Lange procedure The Eden-Lange procedure is an orthopedic surgery, orthopedic procedure to alleviate the symptoms of Accessory nerve disorder, trapezius palsy when more conservative measures, such as spontaneous resolution and Neuroregeneration#Surgery, surgical ...

. Scapular winging due to

facioscapulohumeral muscular dystrophy Facioscapulohumeral muscular dystrophy (FSHD) is a type of muscular dystrophy, a group of heritable diseases that cause degeneration of muscle and progressive weakness. Per the name, FSHD tends to sequentially weaken the muscles of the face, ...

can be treated with a scapulopexy or

scapulothoracic fusion The shoulder girdle or pectoral girdle is the set of bones in the appendicular skeleton which connects to the arm on each side. In humans it consists of the clavicle and scapula; in those species with three bones in the shoulder, it consists of t ...

References

{{DEFAULTSORT:Shoulder Surgery Orthopedic surgical procedures