If the ligament has been completely torn or if the patient is not healing from physical therapy, then the doctor may suggest a complete reconstruction of the ligament in order to prevent further damage and stabilize the shoulder.
Arthroscopic surgery may be performed. Surgery involves the repair, reconstruction and removal of the damaged tissue. A physical therapy program will usually follow the surgery in order to strengthen the muscles and restore full joint mobility.
Arthroscopy is a technique that allows surgeons to visualize, diagnose and treat a variety of joint problems. Rotator cuff tears, ligament tears, tendon tears, damaged and loose cartilage, and many other conditions can all be treated arthroscopically. Arthroscopy is performed using an arthroscope, a small optic instrument that enables a close look at the inside of a joint through a small skin incision.
Arthroscopic surgery was developed as a way to avoid making long skin incisions. While the long incisions allowed surgeons to fully visualize the joint, the subsequent disruption of tissue created long healing times, increased risk of infection and resulted in long scars.
Procedure
Arthroscopic surgery avoids long, invasive incisions by using an arthroscope, a small tube-like instrument that allows the surgeon to see inside the joint. The arthroscope is inserted into the joint through a short incision generally less than 1/4" - 1/2". Several small incisions may be made to see other parts of the joint or to insert instruments. The arthroscope uses a camera that projects the image of the joint onto a monitor. The surgeon is able to view the joint, and its structures, including cartilage, ligaments and surrounding tissue. Once the problem is identified, the surgeon may be able to use specially designed instruments and/or implantable fixation devices to repair conditions or remove any damaged bone or tissue.
Diagnosis & Treatment- Shoulder
Rotator Cuff Tear
Rotator cuff tears include injury to muscles and tendons that connect the upper arm bone (humerus) to the shoulder blade (scapula). These tears occur in many shapes and sizes. If the injury is an incomplete or partial tear, pain may likely be the most prominent symptom. A complete rotator cuff tear may cause significant weakness and pain.
Labral Tear
The labrum is a soft ring of cartilage that surrounds the shoulder socket (glenoid). The shoulder labrum is an anchor for the ligaments that hold the bones together in the joint. A labral tear may occur due to injury, overuse or when the shoulder dislocates (comes out of the socket). Two types of labral tears include the SLAP lesion (Superior Labrum from Anterior to Posterior) and Bankart tears.
Patients with a labral tear may experience pain and catching in the shoulder. Labral surgery may be indicated in patients with persistent symptoms who fail a course of exercise and other conservative measures.
Biceps Tendon Tear
The biceps tendon attaches the biceps muscles to the shoulder, providing leverage for lower arm movement. Tears or ruptures of the biceps tendon can occur from lifting heavy objects, falling on an outstretched arm or playing contact sports. A torn biceps tendon causes pain and swelling.
Complications
Few complications are to be expected with arthroscopy surgery. Those that may occur are infection, blood clot formation, swelling or bleeding, damage to blood vessels or nerves, failure to improve symptoms and breakage or migration of implants.
Recovery
Arthroscopic surgery rarely takes more than an hour or two for isolated injuries. Most patients who have arthroscopic surgery are discharged within the same day. The small skin incision wounds take several days to heal. Several follow-up appointments may be necessary. Typically, during the first of these, the physician removes the sutures, tape or stitches. The patient can usually resume daily activities within a few days, but the injury may require several weeks to months to fully recover.
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