The shoulder is the most flexible joint in the body allowing one a huge range of motion, but the nature of the joint also makes the shoulder susceptible to instability and injury. Sometimes injury or overuse can cause problems at the joint that can be rehabilitated without surgery, but sometimes the damage is so extensive that shoulder surgery is required. Early, correct diagnosis and treatment can make a significant difference in the success of treatment.
Anatomy
The shoulder is a ball-and-socket joint, a joint in which the round end of a bone fits into the cavity of another bone. It is made up of three bones: the upper arm bone, or humerus, the shoulder blade, or scapula, and the collar bone, or clavicle. Delicate ligaments hold all these bones near one another at the joint and can be susceptible to tears, overstretching and injury. The rotator cuff is a group of muscles that connect the humerus to the scapula. These muscles are responsible for much of the stability in the joint and are also susceptible to tears and injury.
Common Problems
Partial and full thickness rotator cuff tears can lead to chronic inflammation and bone spurs in the shoulder joint. Instability of the shoulder joint, another common problem, means that the ligaments, tendons, muscles are not sufficiently holding the bones of the joint together. There is greater movement than is comfortable or safe for the joint. Instability occurs with dislocation as a result of injury or overuse. Osteoarthritis and rheumatoid arthritis are common problems that can destroy the shoulder joint and surrounding tissue.
Treatments
If nonsurgical methods of treatment, such as light exercise, modification of activity and rest, are not successful, surgery may be needed to repair the joint. Sometimes people have chronic instability at the shoulder joint that requires surgery to repair torn and overstretched tissues. Shoulder replacement surgery is often recommended for people with painful shoulders and limited range of motion.
Types of Surgeries
Arthroscopy is the insertion of a thin device with a small lens to look inside the shoulder and relay the images to a monitor. Other instruments are inserted to make repairs, based on what is seen with the arthroscope. Open surgery, on the other hand, is sometimes done with small incisions to repair the joint. There are some risks associated with all surgeries including infection and damage to surrounding tissues. However, these problems are rare due to modern surgical techniques.
Recovery
Recovery of comfort and function after shoulder surgery can take several months. Even if the shoulder feels OK, patients need to refrain from using it for three to four weeks after surgery. A rehabilitation program with a physical therapist is required for prevention of further injury and to gain back range of motion. Generally, patients who comply with their therapies and exercises have a successful outcome after surgery.
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