In some cases of shoulder pain and injury, surgery will need to be performed if the injury is too severe from the start or if the conservative treatment options are not reducing the pain. Below are the main shoulder surgical treatments performed at GSOS.
Rotator cuff repair
A rotator cuff repair is one of the most common surgical procedures for the shoulder. During the operation, the surgeon will be looking to identify the damaged part of the rotator cuff and restore the tendon by cleaning up and reattaching the torn and damaged tendons. This can be done in one of three ways listed below.
Arthroscopic repair: During this treatment, the surgeon will make small incisions and use an arthroscope (tiny camera) and tools to reattach the torn tendon.
Open repair: This treatment option is also known as the traditional approach. The surgeon will repair the tendon through an incision that is several inches long. The deltoid muscle will need to be detached for the surgeon to have a better view of the shoulder and gain access to the torn tendon.
Mini-open repair: This procedure starts arthroscopically when the surgeon removes bone spurs and treats other structures within the joint. Then the surgeon will use a small incision to repair the tendon. The benefit of this option is that it avoids the need to detach the deltoid muscle.
Arthroscopic Subacromial Decompression
This is a treatment option for shoulder impingement syndrome, which is an injury to the muscles between the bones in the shoulder. The surgery starts with the arthroscope entering the shoulder joint. Once in the joint, the surgeon looks for tears in the muscles, tendons, and ligaments. After the joint is examined the physician will smooth off spurs that are contributing to inflammation and impingement on the rotator cuff.
Arthroscopic Shoulder Stabilization
This surgery is needed when the shoulder is considered unstable, meaning it dislocates frequently or slips partially out of the joint. When surgery is needed the common treatment option at GSOS is the arthroscopic shoulder stabilization approach. This surgery uses arthroscopy to reattach the loose or torn ligaments to the joint using implants called suture anchors. These anchors will relocate, tighten and hold in place injured joints. Over time the sutures will disintegrate.
Shoulder Replacement Surgery
According to the Agency for Healthcare Research and Quality, in 2011 about 53,000 people in the United States underwent shoulder replacement surgery.
There are multiple types of shoulder replacement surgeries, also known as shoulder arthroplasty. An orthopedic surgeon will decide on the best option depending on the type of damage, symptoms and patient’s age.
Total shoulder replacement: The entire shoulder joint is replaced with an artificial ball and socket.
Reverse shoulder replacement: An orthopedic surgeon will change the position of the ball and socket joint when placing the prosthetics. This treatment is ideal for patients with large rotator cuff tears and for those with cuff tear arthropathy, also known as shoulder arthritis. After surgery, the deltoid muscle controls the arm and not the rotator cuff.
Partial shoulder replacement or stemmed hemiarthroplasty: In this treatment option the ball aspect of the shoulder joint is repaired with an artificial ball.
Resurfacing hemiarthroplasty: The surgeon will replace the joint surface of the humeral head with a prosthesis cap. The advantage of this surgical option is that it preserves the bone. This is helpful for young or active patients to avoid the risk of artificial replacements wearing or loosening.
The first treatment option for many common conditions that cause shoulder pain is resting the joint and allowing the inflammation to subside. It is important to use caution when resting the shoulder because prolonged immobilizations can cause frozen shoulder.
While resting the shoulder, it can also be helpful to use ice and heat. The ice pack will reduce swelling and pain and is best right after an injury. The heat pad can relax the muscles and reduce pain and is ideal to begin 2 to 3 days after an injury. It is important to remember to not overdo it with heat and ice, only apply the temperature therapy a few times a day for 10-20 minutes.
Your doctor may also recommend taking medication like ibuprofen or aspirin to reduce the pain and swelling.
Physical therapy can be used as a treatment or as rehabilitation after surgery. Depending on the cause for the shoulder pain, our physical therapists will give specific exercises to reduce the symptoms.
For shoulder pain, the most common injection is a cortisone shot to relieve swelling and pain. Cortisone is a steroid that can be administered at the doctor’s office and can provide immediate relief. Cortisone shots can last for multiple months.