Arthroscopic procedures on the shoulder
We perform the following arthroscopic procedures on the shoulder:
- Shoulder lavage – surgery in which we insert a camera through a 1 cm hole in the joint. We look at the inside of the joint on the display and search for every possible trace of damage to the elements which make up the joint (cartilage, labrum, ligaments, tendons). Through another hole or eventually a third one we clean the damaged and degenerated tissue using arthroscopic instruments brackets scissors, motorized instruments and other). Since everything is being watched on a big display and zoomed in, it's possible to do the surgery very precisely.
- Subacromial decompression – it is a procedure where we insert the camera into a space outside the joint, above the rotator cuff tendons, but below the acromion. We always examine the shoulder joint prior to this procedure. In some patients the acromion can have a lightly curved shape or end with a protrusion towards the tendons of the rotator cuff. When lifting the arms above the head, the tendons of the rotator cuff can be pressed against the acromion and the head of the humerus. Inflammation occurs at the beginning which can be treated with analgesics and physical therapy. Later on, degeneration and partial or total rupture of the tendon occurs. When neither physical therapy nor analgesics help, we abrade the excess bone of the acromion and free the space for the tendon. The diagnosis made to the patient is subacromial impingement.
- Removal of calcification of the rotator cuff tendons – procedure went through a few holes the calcifications which formed as part of an inflammatory and degenerative process of the tendon are removed. Diagnosis is Tendinitis calcificans musculi rotatorii (m. supraspinati).
- Rotator cuff reconstruction – type of surgery where because of the rupture of one or more tendons on the attachment to the humerus, we use anchors with threads to reconstruct the attachment of those tendons to their specific place. Magnetic resonance images can show the scale of injury and how much the tendon has retracted. In case it is possible to easily re-attach the tendon, it is necessary to wear an arm orthosis after surgery for 3 weeks. In case of a larger retraction of the tendon, where during surgery the arm must be raised and only then the tendons attached, the patient will have to wear a special orthosis for the shoulder which holds the arm at a distance from the body for five weeks.
- Shoulder stabilization (after dislocation) – surgery where after the contrast magnetic resonance imaging is done, we verify the labrum injury in the shoulder (Bankart injury). We reinforce the labrum to its place next to the glenoid and in that way stop the injury from happening again.
- Fixation of SLAP lesion – surgery where with the contrast magnetic resonance imaging we verify the injury to the superior part of the labrum which is connected to the attachment of the biceps tendon. Then, with anchors on top of which are threads, we reattach the labrum to the glenoid.