Miracle of biology, evolutionary gap: The shoulder joint.
My personal interest as a physician lies for many years in addition to the knee joint, especially in the shoulder joint. The complex interaction of various tendons and muscles with a very small socket in comparison, allow the shoulder joint the largest amounts of movement.
My interest is in the treatment of rotator cuff tears, instability and cartilage wear (osteoarthritis). Here you find an overview of the most common shoulder problems and the appropriate surgical options.
I do perform most procedures arthroscopically. Those are minimally invasive techniques.
However, should it be necessary to replace all or part of the joint, as a surgeon I also have a wealth of experience with this procedure.
Rupture of the rotator cuff
- Tear in the capsule, which encloses the shoulder joint.
- Arthroscopically. Suturing of the tear, Anchoring the sutures in the bone For very large cracks: Closing of the crack with artificial tissue, Anchoring the tissue.
- Dislocation of the shoulder joint. Traumatic as from falls; in some people a congenital shoulder weakness.
- Arthroscopically. Recovery of the socket lip, re-anchoring of the capsule.
- Rupture of the glenoid lip in the region of the attachment of the long biceps tendon.
- Arthroscopically. For young people: Reconstruction of the glenoid lip. In older people: Move of the biceps tendon insertion.
- Rupture of the band between collarbone (clavicle) and coracoid (Proc. Coracoid), whereby the front suspension of the arm is damaged to the fuselage.
- Arthroscopically. Replace the belt by artificial implant or body’s tendon, for example, the thigh.
- Bumping the ball joint on the acromion when lifting the arm, caused by an imbalance of the shoulder muscles as a result of a weakened tendon.
- Arthroscopically. Partial abrading the anterior part of the acromion to restore the natural distance from the ball joint.
- Lime deposits in the tendon capsule as a result of a failed attempt at repair of the human body.
- Shock wave therapy is often possible. Otherwise arthroscopic suction of lime deposits.
Adhaesiva capsulitis, frozen shoulder
- Capsule hardening and -shrinkage with massive inflammation. This causes stiffening of the shoulder, often in the context of metabolic diseases such as diabetes mell.
- Initially no surgery necessary! Conservative Treatment, gymnastics-stretching excercises. After the acute inflammation has subsided, possibly arthroscopic removal of adhesions useful.
- Joint degeneration due to aging, overload or unrecognized pre-existing conditions of the shoulder.
- Arthroscopic removal of diseased tissue, cartilage repair or transplantation. In advanced cases: use of an endoprosthesis.
- Most common are fractures of the clavicle, the glenoid, the glenoid rim or the humeral head.
- Conventional surgical technique. Depending on the diagnosis: Setting up the fracture and stabilization with intramedullary nails or plates and screws. In severe cases: implantation of an endoprosthesis.
- Consequential damage a rotator cuff tear. Total wear of the joint capsule, Often direct contact with the bone of the humeral head and the acromion.
- Implant of an inverse Shoulder Prosthesis.