Orthopaedic Procedures: Shoulder
Our expert Consultant Orthopaedic Surgeons are skilled in all areas of shoulder surgery including both keyhole and open-surgery methods. Surgeries take place in our state-of-the-art theatres with the latest in equipment and groundbreaking technology.
A very small incision is made at the shoulder through which an arthroscope is inserted. This scope has a tiny camera at the tip. The camera live feeds images from inside the shoulder to a video monitor in the operating theatre.
Once the consultant can see the damage inside the shoulder, another one to three small incisions are made. Through these incisions instruments are inserted which allow your surgeon to repair the damage.
The repair includes re-attaching the tendon to the bone. Sometime small rivets (suture anchors) or sutures are used to tie the tendon back to the bone. These are usually made of a special material which will dissolve over time.
This is a type of surgery which is used most often to stabilise and heal broken clavicle bones. If a patient fractures their clavicle, they might need ORIF treatment to realign their bones in order to heal.
During this procedure in the open format, your surgeon reposition your bone pieces, back into their proper alignment. In a closed reduction, your surgeon will physically move the bone back into place without surgically exposing the bone itself.
Open Repair Method
During an open repair, a large incision is made across the shoulder and the large shoulder muscle, the deltoid, is gently moved to the side in order to allow the surgeon to perform the repair in the area below. Once this muscle has been moved aside, your surgeon will re-attach torn tendons to the bone using rivets or stitches. These rivets and stitches are often made of a material which dissolves over time.
Open repair method is usually only used for larger or more complex tears. For smaller or less complex cases, most surgeons will recommend an arthroscopic approach.
Open Subacromial Bursectomy
Bursitis of the shoulder is a painful inflammation within the shoulder joint. Bursitis is an inflammation of the bursae. These are small, fluid-filled sacs found close to joints. They act as cushioning between moving parts in the joint to stop muscles, bones, and tendons from rubbing together painfully.
When a shoulder bursa gets irritated, it becomes inflamed and enlarged. This means there is less space in the shoulder for muscles and tendons to move around, which causes pain and reduces the ability to move the shoulder normally.
An Open Subacromial Bursectomy is a common part of a lot of other surgeries, including subacromial decompression, or rotator cuff repair. It can be undertaken as a primary procedure in the management of bursitis, which hasn’t responded to non-operative treatments. Surgery will be performed to remove the inflamed bursa, thereby preventing free movement of the shoulder. Another symptom would be clicking, while undertaking routine movements.
Rotator Cuff Repair
The rotator cuff is a group of muscles and tendons which form a ‘cuff’ over the shoulder joint. These muscles and tendons have two jobs, they hold the arm in place and they assist the shoulder joint to move. Sometimes, through injury or overuse, these tendons can get torn.
Surgery for repair of a torn rotator cuff is generally done via arthroscopy, this is where a small incision is made and the work carried out through this tiny incision. This method leaves minimal scarring and recovery is often quicker than that associated with a large incision surgery.
Sometimes, a larger incision may be necessary depending on the level of damage to the tendons and joint. Where this is the case, the wound will be larger and may take a little longer to heal.
Both surgeries are carried out under a general anaesthetic (GA). This means that you will be asleep for the duration of your procedure and will not feel anything. Your Consultant will discuss your injury with you and advise you of which surgical method will be most suitable for repair of your injury.
A Shoulder Arthroscopy is a surgery that uses a tiny camera called an arthroscope, to repair the tissues within or around the shoulder joint. The procedure includes an arthroscope being inserted through a small incision.
The surgeon will inspect the tissues within the shoulder joint, using a video monitor. This real time video feed allows the surgeon to repair or remove any damaged tissues. There are many reasons for this procedure to take place, some being: torn or damaged cartilage, torn or damaged biceps, bone spur inflammation around the rotator cuff or arthritis.
Subacromial Decompression is a minimally invasive arthroscopic procedure used to treat ‘shoulder impingement’. Shoulder Impingement is the occurrence of bursitis, inflammation, occasionally tearing of the rotator cuff and bone spur formation within the shoulder. This results in pain and a limiting range of motion.
The goal of this surgery is to smooth off the spur which is contributing to inflammation and impingement of the rotator cuff. This surgery allows the patient a shorter recovery time and less pain in the first few days following the procedure.
Total Shoulder Replacement
Total Shoulder Replacement is a complex procedure whereby the shoulder joint is replaced with artificial parts. Here at Beacon Hospital, our team of shoulder surgeons are experts in their field, ensuring that you are in the safest of hands for this procedure.
Shoulder replacement may be required due to pain caused as a result of arthritis, severe breaks or fractures, or where bone is rubbing on bone within the joint.
The shoulder joint is a ball and socket. In a shoulder replacement operation both the ball and socket may be replaced, or one or the other where both do not require replacing.
The operation is highly successful and patients recover quickly with the assistance of some Physiotherapy and home exercises.