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Common problems either treated or assisted by arthroscopy in shoulder joint:
Recurrent shoulder dislocation, joint coming out of place
- Shoulder dislocation is usually caused by an injury. A traumatic shoulder dislocation, especially in the younger patients, tends to become recurrent due to a failure of the torn ligament (IGHL) and labrum to heal at the correct anatomical location.
- With repeated dislocations, the extent of damage to the bone (Humerus-Hill Sachs lesion, glenoid bone loss) as well as the soft tissues (Bankart lesion, ALPSA lesion) increases.
- MRI scan and CT scan can usually give a fairly good idea about the extent of damage suffered and helps in planning the surgery.
- In patients with a preserved bone stock and good quality soft tissues, arthroscopic labral repair (Bankart repair, ALPSA repair) will give excellent results.
- After the repair, patients are able to get back to leading an active lifestyle including participating in sports.
- SLAP or superior labrum anterior posterior detachments are seen more often in overhead athletes. They are generally caused either by a traction injury to the arm or a fall on an outstretched hand.
- They usually present with a dull aching pain in the upper arm along with a weakness in throwing or overhead activities.
- Various types (more than 7 types) have been described and most of the symptomatic patients need arthroscopic repair of SLAP for recovery and function.
Rotator cuff tears
- The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor and subscapularis) which encompass the shoulder from three sides, top, front and back.
- They are responsible for fine tuning the movements of the shoulder joint, especially so in overhead functioning.
- A full thickness traumatic tear of the cuff results in pain and inability or difficulty in raising the arm overhead.
- A partial thickness cuff tear might present with pain and a decrease in the strength of the shoulder.
- Rotator cuff tears can be repaired arthroscopically with a predictably good recovery on most occasions.
Stiff (Frozen) shoulder
- This is a condition where there is active as well as passive loss of movement in many directions.
- In the early stages, pain, as well as stiffness, is the primary features. Eventually the pain may settle; however, very often the stiffness persists.
- This generally affects people over the age of 50years and is quite common in diabetics.
- The arthroscopic release might be indicated in those patients who do not respond to conservative management.
- This is the situation where there is a bony outgrowth from the undersurface of acromion or anomalous acromion type 3 causing crowding and irritation of rotator cuff, resulting in pain and stiffness in the shoulder.
- This can be settled with arthroscopic subacromial decompression and acromioplasty means shaving off that extra bone with motorized shavers and radio frequency device(RF).
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