Orthopaedic

Shoulder Surgery Treatment

Shoulder Surgery

A shoulder is one of the most flexible joints in the body. It allows a person to place and rotate their arm in many positions in front, above, to the side, and behind even their body. This flexibility also makes the shoulder more vulnerable to instability and injury. Depending on the nature of the problem, nonsurgical methods of treatment are often preferred over the surgery.

What is shoulder surgery?

A shoulder is one of the most flexible joints in the body. It allows a person to place and rotate their arm in many positions in front, above, to the side, and behind even their body. This flexibility also makes the shoulder more vulnerable to instability and injury. Depending on the nature of the problem, nonsurgical methods of treatment are often preferred over the surgery. However, in some cases, delaying the surgical repair of a shoulder can increase the problem that will be more difficult to treat later.

A rotator cuff is a group of muscles and tendons that surround the shoulder joint, which keeps the head of the upper arm bone firmly within the shallow socket of the shoulder. Some rotator cuff problems can be easily treated at home. But if one’s problem is severe, or remains for more than a few months, that person may need surgery.

What Causes Rotator Cuff Problems?

A rotator cuff is a group of tendons and muscles in the shoulder, it helps one to lift and rotate their arm. It also helps keep the shoulder joint in place. But sometimes, the rotator cuff tendons tear or feel more stress by the bones present around.

Surgery

If the patients are not getting any relief with these steps, surgery may be the next best option for them.

The patients may require surgery if:Page Image

  • The shoulder hasn’t improved after 6 to 12 months
  • They have lost a lot of strength in their shoulder and find it painful to move
  • The patients have a large tear in their rotator cuff tendon
  • The patients rely on their shoulder strength for their job or to play sports

What Type of Surgery Do people require?

Surgery may be the perfect treatment for many shoulder problems, particularly those problems that fail to respond to conservative therapy.

Arthroscopy for Impingement Syndrome: Impingement syndrome is a condition in which the tendons of the rotator cuff are intermittently trapped and compressed during movement and thus requires a surgery. This causes damage to the tendons, as well as the cushions that are inside the joint space. This surgical procedure may be done in isolation or as a part of a rotator cuff surgery.

Arthroscopic SLAP Repair: A SLAP (Superior Labrum Anterior and Posterior) tear is an injury to the rim of cartilage which encircles the shoulder socket. A SLAP tear occurs both in anterior and posterior of the shoulder socket.

Arthroscopy for Shoulder Dislocation: A shoulder dislocation injury generally occurs when the ball of the shoulder joint comes out of the socket. In young athletes, the damage generally occurs at the labrum. For stabilizing the shoulder after dislocation, the surgery can be performed which is known as a Bankart repair can attach the labrum to the joint capsule for holding the ball in the place. Other cases involved generalized laxity of the shoulder ligaments which can result in a condition known as multidirectional instability. This can result in the shoulder joint to come in and out of the socket very easily. Surgery would be required for tightening the joint capsule.

Arthroscopy for Frozen Shoulder: Frozen condition can be usually treated with non-surgical means; there are rare instances in which surgical treatment is required. It is the second most common cause of shoulder injury after the rotator cuff tear. When a frozen shoulder occurs, the capsule that surrounds the shoulder joint becomes tight and contracted. The goal of surgery is to lose the contracted tissue that will allow the shoulder to move more freely.

Rotator Cuff Repairs: There are many ways to perform this, and most surgeons have their own preferred techniques. The aim of the surgery is to identify the damaged part of the rotator cuff and reattaching any torn or damaged tendons. Once the healthy tissues are found, the surgeon will use different techniques for restoring the tendon without excessively stretching the remaining tissues

Acromioclavicular Joint Repairs: The acromioclavicular joint (AC joint) is the junction of the end of the clavicle and the acromion. There are various problems that can occur at the acromioclavicular joint. The acromioclavicular joint can wear out, this can occur due to arthritis, generally at the site of previous trauma. It can also be damaged due to a repetitive use injury, such as weightlifting. If either of these conditions occurs, open surgery may be done for removing the end of the collarbone and widening the AC joint space. Instability can also occur at the acromioclavicular joint, which causes damages to the ligaments that connect the clavicle to the end of the shoulder blade. This can result in shoulder separation.

Shoulder Replacement: Shoulder replacement surgery is reserved for the advanced arthritis of the shoulder joint but this surgery can also be used for complex fractures and other problems that cannot be repaired by the use of the other techniques. A typical shoulder replacement is performed to replace the ball and socket joint with an artificial ball made of metal and a socket made of plastic.

What does the Treatment involve?

Home care treatment can treat many rotator cuff problems. The doctor will tell the patients to rest their shoulder joint and ice the area. Medication can be provided like aspirin, ibuprofen, and naproxen to help ease pain and swelling while the rotator cuff heals. Physical therapy is very helpful in restoring shoulder strength.

Possible Complications after Surgery

There are always chances of some risks with any surgery, even with arthroscopic procedures. These include the possible infection and damage to surrounding nerves and blood vessels. After surgery, the patients will experience some pain, tenderness, and stiffness but that is normal. The patients should be alert for certain signs and symptoms that may suggest the development of complications.

Some sign or symptoms are as follows:

  • Fever after the second day following surgery
  • Increase in the pain or swelling
  • Redness, warmth, or tenderness due to the infection in the wound
  • Unusual bleeding

How soon will I recover?

Recovery from arthroscopic surgery is usually quicker than open tendon repair. The patients should expect to be in a sling for about 6 weeks. This protects the shoulder and gives the patient’s rotator cuff time to heal. The patients must drive the car at least a month. A few people don’t get instant pain relief from surgery. The shoulder may require a few months before it starts feeling better. Until then, the doctor will advise taking over-the-counter pain relievers. Physical therapy will play a vital role in recovery. The doctor will give the patients exercises to perform every day. This will help the patients to regain their shoulder strength and range of motion. While the recovery from rotator cuff surgery can be very difficult, most of the people are back to their normal routine within 6 months.

Shoulder Surgery Treatment in India

Shoulder is a ball and socket joint which is made up by three bones:

  • The humerus (upper arm)

  • scapula (shoulder blade)

  • clavicle (collarbone). 

A strong connective tissue that envelops your shoulder joint holds everything and this connective tissue is called a shoulder capsule. Shoulder joint has the highest mobility than any other joint in our body.

Causes of shoulder pain:

The following are some typical reasons of shoulder pain:

  • Dislocation of the shoulder: The humerus slides out of the shoulder socket.
  • Slap tear: A tear in the cartilage cuff that covers the humerus in the shoulder joint is known as a SLAP tear.

  • Bursitis and tendonitis: Inflammation of the bursae (fluid-filled sacs that reduce friction) and tendons is known as bursitis and tendonitis.

  • Frozen shoulder: Joint stiffness associated with frozen shoulder.

  • Ligament strains and muscle strains.

  • Arthritis.

  • Cervical radiculopathy: shoulder discomfort that travels down the arm and forearm as a result of disc and vertebral neck pathology.

  • Harm to the brachial plexus:damage to the main nerve plexus that supplies the arm.

  • A tear in the rotator cuff, which stabilizes the shoulder joint, occurs in the rotator group of muscles.

Frozen Shoulder

The condition known as frozen shoulder, often referred to as adhesive capsulitis, restricts movement in the shoulder joint. Usually, you have discomfort and stiffness that starts slowly, gets worse, and eventually goes away. 

Causes of frozen shoulder

Frozen shoulder is said to occur when the shoulder capsule gets extremely tight and thick, making movement difficult. In order to keep the joint lubricated, less synovial fluid is present, and bands of scar tissue grow. Your shoulder range of motion is further restricted by these activities.

Because you use your shoulder less as it becomes more uncomfortable, the condition is known as "frozen" shoulder.  Your shoulder capsule thickens and gets harder to use. You feel as though your shoulder is "frozen" in place. 

Frozen shoulder treatment in India

Managing discomfort is usually the first stage of treatment; if the problem continues and recovery from normal motion is not achieved, therapy or surgery may be necessary.

Non surgical and first line of treatment:

  • Hot or cold compresses: Using compresses that are hot or cold helps reduce pain and swelling.
  • Medication for pain and swelling: Ibuprofen and acetaminophen are typical nonsteroidal anti-inflammatory medicines (NSAIDs) used to treat pain. For more severe discomfort and swelling, steroid injections that involve a direct injection into the shoulder joint may be recommended.

  • Physical therapy: Patients are guided through range-of-motion and stretching exercises by physical therapists.

  • Exercise routine at home: Patients are urged to maintain their exercise schedule at home.

  • Transcutaneous Electrical Nerve Stimulation (TENS): By obstructing nerve impulses, this tiny battery-powered gadget reduces pain.

Surgery or shoulder arthroscopy: 

By making cuts through the tightly packed areas of the joint capsule, the surgeon carries out a capsular release during shoulder arthroscopy. Minor incisions are made around the shoulder to introduce small, pencil-sized devices. 

Shoulder dislocation treatment in India

The degree of the injury and whether it is a first-time or recurring dislocation determine the course of treatment for a dislocated shoulder. For a dislocated shoulder, common treatment options in India include the following:

  • Closed reduction: A medical practitioner may carry out a closed reduction following a dislocated shoulder, which involves moving the joint to realign the humerus. Usually, this operation is performed for first-time dislocations without any serious accompanying injuries.
  • Immobilisation: After reduction, a brace or sling is frequently used to immobilize the shoulder. By stabilizing the shoulder, this lowers the chance of recurrent dislocation and promotes healing. Although the length of immobilization varies, a phase of rehabilitation usually follows.

  • Surgery: Surgical intervention may be recommended in cases of considerable structural damage or persistent instability. 

  • Medications: Painkillers and anti-inflammatory drugs may be provided to treat pain and minimize inflammation during the acute stage. 

  • Rehabilitation: Rehabilitating the shoulder to restore its strength, flexibility, and functional use is a crucial component of the therapeutic process. 

Diagnostic tests before shoulder pain treatment in India

To identify the precise origin of the issue, the surgeon may perform a physical examination and may prescribe X-rays, CT scans, or even an MRI. To find the issue or determine the level of damage, a shoulder arthroscopy may be required.

Shoulder pain treatment options for International Patients in Indian Hospitals 

Patients who visit us, particularly those from the Maldives, UAE, USA, Germany, United Kingdom, etc., can receive a variety of treatments from us for sports injuries, shoulder, knee, ankle, hip, elbow, and other joint problems. The orthopedic shoulder specialties that we provide to our foreign guests include the following:

  • Shoulder replacement
  • Shoulder arthroscopy

  • Shoulder stabilization surgery

  • Acromioplasty

  • Rotator cuff repair

  • Shoulder dislocation

  • Ligament surgeries

Various Shoulder Surgery Procedures at India's World-Class Hospitals

Depending on the particular surgery, several protocols and techniques are employed in shoulder surgery. When performing shoulder surgery, one of the following methods is typically used:

Minimally invasive surgery or arthroscopy: this is carried out by making small incisions in your shoulder to introduce an arthroscope and specific tools. An arthroscope is a small, illuminated device with a built-in camera. While your surgeon is performing the surgery, the camera sends images of the inside of your joints to a video screen. Instead of using the bigger incisions required for open surgery, your surgeon will use smaller ones. Instead of cutting through or displacing organs and structures as in open surgery, he or she can then thread surgical instruments around them. 

Benefits of minimally invasive surgery:

  • Quicker recovery

  • Less pain

  • Lower complications

Open surgery: in certain cases, an open surgery might be required and, in certain circumstances, might yield better outcomes than arthroscopy. Small incisions of only a few inches are frequently sufficient to do open surgery. Whether an open or arthroscopic surgical procedure was used to operate on the shoulder will determine the course of recovery and rehabilitation.

 Mini open surgery: With the use of more advanced technologies, mini-open surgery combines a smaller open procedure with minimally invasive arthroscopic procedures. Compared to an open surgery incision, this involves one to two-inch smaller incisions. With this method, some surgeons are able to do more comprehensive repairs than they could with minimally invasive surgery. It results in less harm than open surgery.

Best Hospitals in India for shoulder surgery

Selecting the top hospital in India for a shoulder surgery is a crucial choice that can directly affect how the surgery turns out. These are some of India's top hospitals for shoulder surgery:

  • Fortis Memorial Research Institute, Gurugram
  • Medanta The Medicity, Gurugram

  • Artemis Hospital, Gurugram

  • Marengo Hospital, Gurugram

  • Fortis Flt Lt Rajan Dhall Hospital,Vasant Kunj, New Delhi

  • Max Hospital,Delhi

  • Apollo Hospital,Delhi

Best surgeons in India for shoulder surgery 

The top surgeons in India for shoulder surgery are listed below:

  • Dr. Subhash Jangid
  • Dr Jayant Arora

  • Dr. Ashok Rajgopal

  • Dr. Raman Kant Aggarwal

  • Dr. I P S Oberoi

  • Dr. Ramkinkar Jha

  • Dr. Hemant Sharma

  • Dr. Rajesh Kumar Verma

  • Dr. Manoj Miglani

  • Dr. Gurinder Bedi

  • Dr. S K S Marya

  • Dr. Vikas Gupta

  • Dr. Amit kumar Agarwal

  • Dr. Masood Habib

We at Get Well Go will assist you in getting expert advice and the best treatment from a panel of surgeons. You can contact us via phone at +91-9289678787 or email us at care@getwellgo.com

 

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