shoulder surgery Archives | Mathew Mazoch, MD

Bone & Joint Clinic of Baton Rouge | Sports Medicine


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All Posts Tagged: shoulder surgery

Rotator Cuff Tear Repair Surgery

Overview of Rotator Cuff Tear Repair Surgery

The rotator cuff is a common source of pain in the shoulder. It refers to a group of four muscles and tendons that attach to the head of the humerus and stabilizes the shoulder as it moves in space. The most commonly affected tendon is the supraspinatus tendon.  Issues with the rotator cuff commonly cause problems with overhead activity, pain with sleeping on the shoulder, and moving the shoulder in certain motions.  If torn, the rotator cuff can cause progressive pain and disability in the shoulder.  Unfortunately, the rotator cuff has poor healing potential on its own and often requires surgical repair in many cases.

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The image shows a stylized view of the shoulder with a small anterior supraspinatus tear.

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Rotator Cuff Impingement, Bursitis, & Tendinitis

Overview of Rotator Cuff Impingement, Bursitis, and Tendinitis

Shoulder pain is one of the most common problems in patients or in athletes who deal with overhead movements of the shoulder.  One of the most common reason for shoulder pain is a problem with the rotator cuff or the surrounding tissues.  The rotator cuff is a group of four muscles that attach to the humeral head and the scapula and help move the shoulder in space.  The rotator cuff and overlying bursa can sometimes become inflamed if the rotator cuff muscles hit the undersurface of the acromion.

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Biceps Tear or Injury

Introduction to Biceps Tears or Injuries

The biceps muscle goes from the shoulder to the elbow on the front of the arm. Two separate tendons connect the upper part of the biceps muscle to the shoulder, the long head tendon and the short head tendon.  The long head of the biceps connects the biceps muscle to the top of the shoulder socket, the glenoid.  The long head of the biceps tendon runs within the bicipital groove.   The short head of the biceps connects on the corocoid process of the scapula.  The lower biceps tendon is called the distal biceps tendon and it attaches to the radial tuberosity in the forearm.  The biceps is most commonly injured at the long head and more rarely it can be injured at the distal biceps tendon.  Depending on where it is injured and the finding depends on how the injury needs to be treated.

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This diagram shows the basic anatomy of the biceps tendon in the arm.

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SLAP Tear in the Throwing Shoulder

Introduction to a Slap Tear in the Throwing Shoulder

The shoulder has the most range of motion of any of the major joints in the body. Maintaining stability in this highly mobile and versatile joint requires a finely tuned combination of many structures in the athlete.  The socket (glenoid), the cartilaginous rim around the socket (labrum), the capsular ligaments, and the rotator cuff muscles all play a role in stability.

A frequent cause of pain or instability of the throwing shoulder is a labral tear.  A particular kind of labral tear involving the superior labrum is a SLAP (Superior Labrum Anterior to Posterior) tear.  This tear originates where the long head of the biceps tendon attaches to the labrum and glenoid.

SLAP tears can be traumatic, from overuse, or degenerative.  Repetitive forces such as those seen with overhead and/or throwing athletes are frequently responsible for SLAP lesions.  Other common mechanisms of injury include blows to the shoulder, a fall on an outstretched arm, seatbelt/shoulder harness injuries, or heavy lifting.  People with a SLAP tear often feel a deep-seated pain often referred to the back of the shoulder.  But depending on the extent of biceps involvement can be felt anteriorly as well.  Sudden movements or extremes of motion, especially outwards and upwards as in throwing, often bring on the pain. Occasionally, catching sensations or instability symptoms are also felt.

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Shoulder Arthritis Pain and Shoulder Replacement

Shoulder Arthritis Pain

Arthritis means “inflamed joint,” and refers to any condition of the joint in which there is damage to the smooth cartilage covering a moving surface of a joint (called the articular cartilage).  Progression of arthritis eventually leads to cartilage loss and “bone on bone” of the joint surfaces.  Cartilage damage and loss can cause pain.

After the hip and knee, the shoulder is the third most common large joint affected by arthritis.  The loss of cartilage with shoulder arthritis is frequently a source of severe pain, limited function, joint stiffness, and significant diminished of quality of life. While there is currently no cure for advanced arthritis, there are many treatments, both non-surgical and surgical, that enable the symptoms to be well treated and for patients to maintain active lifestyles.

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The image shows a patient’s x-ray with primary osteoarthritis

 

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Shoulder Dislocation & Instability

Introduction to Shoulder Dislocation and Instability

The shoulder joint consists of the rounded top of the bone in the upper arm (humerus), which fits into the socket (glenoid) — the cup-shaped outer part of the shoulder blade.  When the top of the humerus moves out of its usual location in the shoulder joint, the shoulder is said to be dislocated.

Shoulder dislocations can occur after a traumatic event or can be atraumatic in people who are loose jointed.  In a dislocation event sometimes the structures around the shoulder can be damaged and can cause labral tears or rotator cuff tears.  Proper treatment is necessary to prevent recurrent instability of the shoulder joint which can cause continued dislocations and progressive damage if not treated appropriately.

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This image shows a normal shoulder relationship of the humerus to the glenoid as well as an anterior dislocation and a posterior dislocation.

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Shoulder Labral Tear

Overview of Shoulder Labral Tear

The shoulder is made up of three bones: the shoulder blade (scapula), the humerus (upper arm bone), and the clavicle (collarbone).   A part of the scapula, called the glenoid, makes up the shoulder socket. The glenoid is very shallow and flat. The labrum is a rim of soft tissue that makes the glenoid socket deeper so that it molds to fit the head of the humerus.

The labral tissue can be caught between the glenoid and the humerus. When this happens, the labrum may start to tear or get damaged. If the tear gets worse, it may become a flap of tissue that can get caught between the head of the humerus and the glenoid and cause pain.  The labrum combined with the ligaments, tendon, and capsule all contribute to the stability of the shoulder.  When people develop a labral tear the shoulder often becomes much less stable.

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This is a look at shoulder from the side with the humerus and muscles removed. The labrum is the rim of tissue that surrounds the glenoid.

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