Shoulder and Elbow
Over the last decade, significant advances have been made in the treatment
of shoulder conditions – and here you'll find those advances
being used to benefit our patients every day. Our comprehensive services
include the entire range of orthopaedic and sports medicine care: from
the latest surgical interventions to state-of-the-art rehabilitation designed
to accelerate recovery.
Our fellowship-trained experts are using new breakthroughs – such
as reverse shoulder replacement – to successfully help patients
whose injuries were once considered beyond repair. Equally important,
new minimally-invasive techniques – including arthroscopic rotator
cuff repair and arthroscopic reconstruction for instability – are
allowing us to dramatically reduce recovery times.
From common overuse injuries to the most complex reconstruction and revision
surgeries, our highly experienced orthopaedic and sports medicine surgeons
are creating outstanding outcomes for patients of all ages.
Frequently treated conditions and procedures include:
- Shoulder scope
- Shoulder replacement
- Elbow scope
- Elbow replacement
- Rotator cuff injury
- Shoulder impingement (bursitis)
- Dislocations
- Labral tears
- Shoulder instability
- Shoulder separation (acromioclavicular joint injury)
- Fractures
- Overuse injuries
- Frozen shoulder (capsulitis)
Arthoscopic Shoulder Surgery
Arthroscopic shoulder surgery is a minimally invasive procedure performed
through several small (half inch) incisions using a surgical video camera
and specialized instruments that grasp and manipulate the internal structures
of the shoulder. This allows the surgeon to correct problems in the joint
without the use of a traditional open incision.
Rotator cuff repair
The rotator cuff is a tendon that covers the ball of the “ball and
socket” shoulder joint. Just like the cuff of your shirt going around
your wrist, the rotator cuff goes all around the shoulder, making it important
for your range of motion in all directions. If there is a tear in the
rotator cuff, the patient will typically have difficulty moving the arm
in one or more directions. Other common symptoms of a tear include weakness
and night pain that disturbs sleep. Usually an MRI (magnetic resonance
imaging) scan is needed to determine the size and location of the rotator
cuff tear so that your surgeon may decide if surgery is right for you.
If surgery is needed, our team of surgeons are ready with the latest techniques
and technology for reliable rotator cuff repair and healing, including
biologically “vented” anchors that bring bone marrow stem
cells to the repair site and soft tissue “grafts” that may
be used to patch up a large gap in the rotator cuff. For certain patients
who have a large tear that cannot be repaired with traditional techniques,
we offer newer surgical techniques such as “superior capsular reconstruction”
and rotator cuff “graft augmentation.”
Shoulder Repair for Instability (dislocation)
Shoulder dislocation, called instability, is most common among younger
active patients who have sustained trauma from their athletic activities.
Because the shoulder has such a large natural range of motion, it also
has the highest risk of dislocation of all the large joints in our body.
Following a shoulder dislocation, the labrum, which is the soft tissue
ring around the shoulder socket, often gets torn. This leads to a tendency
for the shoulder to dislocate again, because a healthy labrum’s
job is to keep the ball centered in the socket. For patients with unstable,
painful shoulders who have not healed with conservative treatment, our
surgeons will routinely perform minimally invasive arthroscopic labral
repairs and reconstructions, including arthroscopic remplissage (bone
divot filling procedure) to stabilize and strengthen the shoulder.
Total Shoulder Replacement
Traditional: The standard or traditional shoulder replacement is used to
treat bone on bone shoulder arthritis that has not responded to conservative
treatments, including physical therapy, medications, and injections. This
surgery is similar to a knee or hip replacement, and involves resurfacing
the arthritic ends of the ball and socket joint with specially designed
orthopedic implants. Our surgeons perform the anatomic total shoulder
replacement, which strives to keep the patient’s normal surrounding
tendons, ligaments, and other soft tissue so that the newly replaced shoulder
joint feels more natural and has greater range of motion.
Arthroscopic Rotator Cuff Repair
Our orthopaedic surgeons specialize in one of the newest and most important
advances in the treatment of rotator cuff tears: arthroscopic repair.
For many of our patients, this minimally-invasive, outpatient procedure
is making a significant difference in comfort and recovery while offering
outstanding clinical outcomes.
Instead of the traditional open surgery or mini-open approach in which
muscle is detached, delicate arthroscopic instruments and techniques allow
our surgeons to successfully repair this common injury through three to
four very small puncture wounds. By preserving the deltoid muscle, most
patients experience better range-of-motion, accelerated rehabilitation,
as well as less pain and scarring.
Reverse Shoulder Replacement
For those with a torn rotator cuff and shoulder arthritis, simply raising
their arm can be extremely painful, if not impossible. A new and innovative
shoulder replacement surgery features a reverse ball/socket technique
that can dramatically lessen pain and improve function – even for
patients with extensive rotator cuff damage, instability or a previous
failed surgery.
In the healthy shoulder, the upper arm bone (humerus) ends in a ball shape
which fits into a socket formed by the shoulder blade (scapula). With
a reverse shoulder replacement, the anatomy, or structure, of the healthy
shoulder is reversed: the ball portion is attached to the scapula and
the socket is placed at the upper end of the humerus.
By reversing the ball and the socket, the deltoid muscle (the large shoulder
muscle) becomes more efficient and often compensates for the torn rotator
cuff – allowing patients to regain their range of motion and quality of life.