Shoulder Treatments

Mr Sathyamoorthy is a consultant orthopaedic surgeon specialising in the treatment of shoulder problems including repair and replacement in Wrexham and Chester. Whether your shoulder pain is a result or a sporting injury, trauma or ageing, Mr Sathyamoorthy will diagnose and treat the issue, restoring movement and reducing pain.

Some of the shoulder treatments he provides are outlined below:

Shoulder arthroscopy

Shoulder arthroscopy is a type of keyhole surgery used to diagnose and treat problems associated with the shoulder joint. An arthroscope, which contains a tiny camera, is inserted into the cavity of the shoulder through a small incision. Guided by footage on a monitor, the surgeon can explore the joint through a number of other small incisions used to insert his instruments. There are lots of benefits to keyhole shoulder surgery:

  • Less post-operative pain
  • Less time in hospital
  • Quicker recovery times
  • Very few stitches
  • Less chance of wound complications

Procedures performed with this method include:

Subacromial decompression (commonly known as SAD or ASD)
Subacromial decompression is a shoulder operation used to treat pain caused by shoulder impingement – when the bones and tendons in your shoulder rub against each other. The procedure will be performed under a general anaesthetic and patients are expected to go home the same day or the next morning. Following the procedure patients will need to wear a sling for around 10 days.

Acromioclavicular joint excision (commonly known as ACJ excision)
Acromioclavicular joint excision aims to remove the painful and damaged acromioclavicular joint (ACJ) that links the collar bone to the shoulder blade. In some instances, removing this joint can improve the function of the shoulder joint and decrease the pain. Following the procedure patients will need to wear a sling for around 10 days.

Rotator cuff repair
The rotator cuff is a group of muscles and tendons over the shoulder joint. When torn or injured they can require surgery to repair. It is a common cause of shoulder pain, especially in older people – where it may have developed over years of wear and tear on the shoulder joint. A rotator cuff repair will stitch the torn tendon back onto the arm bone. Patients will need to wear a shoulder sling for at least three to six weeks following surgery.

SLAP repair

A SLAP tear or Superior Labrum Anterior and Posterior tear, to give it its full name, is a torn piece of cartilage in the inner area of the shoulder joint. It is painful and can limit movement of the shoulder, especially reaching up. It can develop over time due to repetitive movements or as a result of acute trauma or age. SLAP repair is tailored to each individual.

Biceps tenotomy and Biceps Tenodesis

Strength loss and shoulder pain are both symptoms of damaged bicep tendons. When the long head of the biceps muscle is torn or detaches from the shoulder due to injury or overuse, Mr Sathyamoorthy will suggest one of two surgical procedures to repair it, depending on your lifestyle and the injury sustained.

Shoulder stabilisation (also known as labral repair, Bankart’s repair, anterior stabilisation, posterior stabilisation)

Shoulder stabilisation is performed on patients who have dislocated their shoulder. When the shoulder dislocates the lining is stretched and a piece of fibrous tissue detaches from the edge of the front socket – also known as a Bankart lesion. The surgery to repair this is usually a day case.

Shoulder replacement

Shoulder replacement in the UK is very common and involves replacing the shoulder joint when it gets damaged or worn by arthritis or through an injury. Sufferers may experience painful and stiff shoulders as a result of cartilage damage. Replacing the shoulder will improve arm movement and reduce or eradicate pain. The procedure normally lasts for around two hours. A metal or plastic artificial shoulder joint will last for at least 10 years. Mr Sathyamoorthy provides two different variations of this procedure:

  1. Total shoulder replacement
    This is also known as shoulder arthroplasty and involves replacing the damaged joint ‘ball’ with a metal ball and putting a new smooth plastic surface on the socket.
  1. Reverse total shoulder replacement
    The reverse total shoulder replacement puts the ball on the patient’s own socket and a plastic socket is fitted to the top of the upper arm. So the ball and socket switch places. This method has more stability and doesn’t require the tendons to hold it in place. This is done for patients who have no functional rotator cuff left and have arthritis causing pain and difficulty in raising the arm.
  1. Partial shoulder replacement or a hemiarthroplasty
    Here only the ball of the shoulder is replaced.This is done either by just resurfacing the patient’s own bone with a thin shell of metal[ known as resurfacing hemiarthroplasty] or by replacing the entire ball [hemiarthroplasty].The choice depends on the quality of the bone.
Internal fixation for shoulder fractures

Injuries resulting from a fall – landing on the tip of the shoulder, on out-stretched hand or bent elbow will transmit force to the humerus (arm bone) which will fracture given sufficient clout. If fragmented or displaced it may require open surgical repair and sometimes replacement with an artificial joint.

Broken collarbones are a common injury incurred when falling and landing on the side. Most injuries of this type can be treated non-surgically with slings. However occasionally displaced fractures or joint separation may need surgical repair.

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