The shoulder is a unique joint allowing the greatest range of motion in the body. This includes allowing us to do remarkable positioning of our arm for intricate hand use, while also allowing us to throw a fastball at over 100 mph! Because of this, unlike the hip joint which is a ball a socket surrounded by bone, the shoulder joint is best described as a ball on a saucer, with limited bone constraints. Using a combination of muscular and ligamentous attachments, the humerus is kept centered on the glenoid to allow stable, strong motion. The purpose of surgery to the shoulder is to maintain this relationship. Arthroscopic repair of the Rotator Cuff Tendons or the gleno-humeral ligaments serves this purpose.
Using a combination of open and arthroscopic techniques, we can restore the relationship of the gleno-humeral joint and its supporting ligaments and tendons. Traditionally, open procedures, with large incisions, were used to achieve this goal. We still use this technique for joint replacement and complex fracture surgery. However, now we do most shoulder repairs arthroscopically, through using small incisions, cameras and specialized equipment. This allows better visualization of the damage, and better access allowing us to repair the injury as close to normal as possible. Using anchors with sutures attached and placed into bone, the sutures are then used to repair the damaged tissue directly back to where it belongs. This is the premise for rotator cuff tendon and ligament repairs.
SHOULDER SURGERY RECOVERY
Given the complexity of the shoulder, recovery from surgery is dependent on the procedure performed. Local anesthetic blocks, pain medications, ice and immobilization are among the numerous tools used for post-operative pain control. Although our goal is to regain mobility and strength in the long term, initial post-operative use of a sling is required. For complex repairs of the rotator cuff and ligaments, more prolonged immobilization of up to 6 weeks to allow for proper healing is needed. Dr. Heinen will tell you when you can stop the sling. After this period of immobilization, home exercises and formal physical therapy are utilized. Motion exercises followed by progressive strengthening and return to activities over months is expected.