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Sports Medicine | May 20, 2018

There are many different types of shoulder surgery, but four methods stand out. They naturally align with the most common shoulder complaints or injuries.

Debridement

This type of procedure is often suggested for patients who have not had a tear, but who have a history of chronic shoulder pain that other treatments (such as oral pain medications, injections, and physical therapy) have failed to resolve

Debridement is a minimally invasive arthroscopic surgery that uses a few very small access points to remove irritated or inflamed tissue, scar tissue, and/or bone spurs that may be impinging on healthy tissue as well as any debris from inside the joint that may be causing pain.

This type of outpatient surgery often takes less than 1 hour, and requires the use of a sling for 2-4 weeks after, at which time patients can begin physical therapy to regain flexibility, strength, and range of motion. A full return to sports can be made often within just a few months.

Labral Tear Surgery

The shoulder joint is a ball and socket joint with a soft tissue “bumper” called the labrum. The labrum is attached to the tendon on top of the shoulder, and surrounds the bony part of the shoulder socket, encapsulating and protecting it. When repetitive motion takes place (such as golf swings, tennis swings, throwing a football or baseball, or serving a volleyball) or a severe shoulder dislocation takes place, the labrum can be torn away from the bone.

Arthroscopic labral tear surgery can repair many of these types of injuries through small access points that allow anchors to be placed and the labrum firmly compressed and be tied back against the bone.

This type of outpatient surgery usually takes around 1 hour, and requires the use of a sling for 4-6 weeks after, at which time patients can begin physical therapy to regain flexibility, strength, and range of motion. A full return to sports to sports can typically be made within 3-4 months.

Rotator Cuff Repair

Rotator cuff tears may be related to an injury such as a fall or a sudden jerking movement, repetitive use injury, or as a result of wear and tear from aging. The rotator cuff is the tendon attachment of four small muscles to the upper part of the arm bone, helping to hold the ball in the socket. When the cuff is torn, the upper end of the arm bone moves up and hits the roof of the shoulder. This causes impingement and can make it difficult to raise you arm above your head or even enough for a handshake.  

Minimally-invasive arthroscopic techniques with specially designed instruments can often be employed to complete the repair via small access points, with small anchors being placed and the tissue compressed and tied back to the bone.

This type of outpatient surgery typically takes about an hour and a half and requires the use of a sling for 4-6 weeks after, at which time patients can begin physical therapy to regain flexibility, strength, and range of motion. A full return to sports to sports can typically be made within 4-6 months, but you can continue to improve for up to a year.

Shoulder Replacement

Arthritis of the shoulder can still cause significant pain and disability as the protective cartilage in the shoulder does not regenerate. Early stages of this condition may allow the use of debridement as mentioned above, to clean out debris and debride any loose flaps of cartilage. Otherwise, one of the three main types of shoulder replacement may be used:

  • Hemiarthroplasty, which replaces just the upper part of the arm bone to treat arthritis on the ball part of the socket (typically used for younger patients)
  • Total shoulder arthroplasty, which is typically reserved for the older population to treat the pain related to shoulder arthritis.
  • Reverse total shoulder replacement for patients who do not have a functioning rotator cuff.

Each of these procedures typically requires overnight stay in the hospital, recovery is typically 3-4 months, and a return to sports will depend on a variety of factors.

Not sure what kind of shoulder surgery you need – or if a non-surgical option is available? Schedule a consultation with Dr. Strasburger today.