Shoulder surgery

Injuries to the acromioclavicular joint (AC joint), which sits at the top of the shoulder, are common. They can be caused by injury, aging or arthritis. 

AC joint arthritis can cause pain and lead to bone spurs. Usually the injuries are not serious and go away with rest, medication and/or steroid shots. If nonsurgical treatments don’t help, minimally invasive surgery may be needed.  

There are many bones in the shoulder area that can fracture (break). These include the clavicle (the collarbone). Most fractures are the result of falling onto the shoulder. They can also happen if too much pressure is put on an outstretched arm.

Most fractures can be treated using nonsurgical options, such as wearing a sling. For more complicated fractures, surgery may be needed. 

Pain and stiffness in the shoulder joint is known as frozen shoulder. The exact cause is not understood. Risk factors include being age 40 or older and being female.  

Symptoms include a stiff shoulder and limited range of motion. This can make it difficult to do practical things, like raise your arms over your head, put on a coat or reach for your wallet. If you have any of these symptoms, your doctor will do an exam. 

If frozen shoulder is caught early, anti-inflammatory medication, physical therapy and steroid shots often relieve pain and symptoms. If your pain lasts for a long time, surgery may be needed. This will be followed by physical therapy. 

The labrum is a piece of rubbery tissue in the shoulder joint, where the arm meets the body. It helps keep the arm bone in place. Sometimes it tears because of injury or age. It’s usually diagnosed after a physical exam and X-rays or an MRI. 

Treatment depends on the severity of the tear and its location. Options include rest, physical therapy or surgery. 

Sometimes pieces of bone or cartilage (the protective covering on the ends of bones) get trapped in the shoulder joint area, where the arm meets the body. These pieces are called loose bodies. They happen because of age, injury or trauma.

Loose bodies can make the shoulder joint catch and lock. They can also cause pain and restrict range of motion. Treatment depends on the symptoms and can include anti-inflammatory medication or minimally invasive surgery. 

The pectoralis muscle is the large muscle in the front of the chest. When it tears, it causes sudden pain and you may feel or even hear a pop. You can also have pain in the upper arm and bruising above the arm pit. 

If this happens, call your doctor. You should be referred immediately to a surgeon. Repairs are more easily done shortly after the injury.  

The rotator cuff is made up of four tendons that keep the upper arm bone in the shoulder socket. Rotator cuff tears involve one or some of these tendons tearing away from the bone.

Tears can be caused by injury, repetitive motion and age. By age 60, nearly half of the population has a tear. The larger the tear, the greater the loss of function. Tears don’t heal on their own and tend to get larger over time. 

Rotator cuff tears often respond well to nonsurgical treatments. These include over-the-counter medications like ibuprofen and naproxen, physical therapy and careful use of steroid shots. 

If surgery is needed, it will be done using small, half-inch incisions. Afterward, your arm will be in a sling for approximately six weeks to give the tendons time to heal. Physical therapy follows. 

Rotator cuff tendonitis, also called shoulder impingement syndrome, is best managed without surgery.

Anti-inflammatory medications and steroid shots can be help. In severe cases, surgery may be done to remove a small bone spur or inflamed tissue.

The shoulder is the body’s most mobile joint. An injury or fall can cause the top of the arm bone to pop out of the shoulder socket. This is known as a dislocated shoulder. If you think you’ve dislocated your shoulder, call your doctor. 

Once you’ve had a dislocated shoulder, it’s more likely to happen again. Also, having a dislocated shoulder increases your chances of developing an arthritic shoulder later in life. Treatment may include nonsurgical options or surgery. 

A partial dislocation of the shoulder joint is more common than a total shoulder dislocation. It happens when the top of the upper arm bone comes partly out of the shoulder socket. 

Treatment depends on how serious the dislocation is. If surgery is needed, minimally invasive surgery will be used. Also, depending on your situation, strengthening the shoulder muscles can help prevent a partial dislocation from happening again.

The bicep is the muscle in the upper arm. It’s connected to the shoulder and the elbow by several tendons. Sometimes one of these tendons ruptures (tears). The tear can be partial or complete. 

Tears can be caused by a fall, lifting heavy objects, overuse, aging or other reasons. Symptoms include sharp and sudden pain, a snapping sound, tenderness and weakness. Bicep tears are also associated with rotator cuff tears. 

The rotator cuff is a group of muscles that keep the upper arm bone in the shoulder socket. Tears can be caused by aging, injury and sports. Injuries are common in people who do repetitive overhead arm motions, like painters or baseball players.

Symptoms include arm pain and weakness. You may also notice a crackling feeling when the shoulder is moved. Treatment includes rest, medication and strengthening exercises. Steroid shots and wearing an arm sling may also help.

Rotator cuff tears don’t heal on their own and can become larger and more serious over time. Because of this, surgery is advised for people who are physically active.

Sometimes the shoulder joint wears out due to age, trauma or arthritis. When this happens, shoulder replacement surgery is necessary. The type of surgery you need will be decided after a physical exam and X-rays or other types of imaging are done. 

Shoulder replacement involves removing damaged parts of the shoulder and replacing them with metal or plastic artificial parts. 

Reverse total shoulder replacement

Reverse total shoulder replacement is a special surgery. It’s used to repair serious shoulder problems, like large rotator cuff tears and severe arthritis. It might also help patients who tried other treatments that didn’t work, including shoulder surgery.

Reverse total shoulder replacement is more difficult than a standard shoulder replacement. Because of this, it’s important to pick a surgeon who is an expert in the procedure.

A shoulder separation happens when one of the ligaments that connects the collarbone to the shoulder blade is torn. This causes the collarbone to move out of place and push against the skin near the top of the shoulder. 

Patients usually recover with time. If the condition is serious, surgery may be needed. 

If you have pain, numbness in certain arm positions, or pain and weakness in the back of the shoulder, you may have suprascapular nerve entrapment or thoracic outlet syndrome (TOS). A shoulder surgeon can help diagnose these conditions during a physical exam.

Treatments include physical therapy and over-the-counter medications. If symptoms continue, surgery may be needed.