Thursday, 17 of January of 2019

Tag » should surgery

Shoulder Replacement

For people with severe shoulder pain, shoulder replacement surgery is usually the right choice once more conversation options such as injections and physical therapy fail to provide relief. Although not as common hip or knee replacement (about 900,000 patients every year versus 53,000 per year according to the Agency for Healthcare Research and Quality), shoulder replacement is a very successful and effective procedure.

Who is  a candidate?

The typical candidate for shoulder replacement is someone whose shoulder joint has been severely damaged with osteoarthritis. Symptoms include shoulder weakness and loss of motion, pain that wakes them up at night and difficulty with even simple daily activities that require you to lift or use your arm.

What exactly is replaced?

The shoulder joint includes two bones: the upper arm bone, called the humerus, and the shoulder bone, or scapula. The tip of the humerus, which is shaped like a ball, fits into the part of the scapula that is shaped like a socket. During surgery, the ball of the humerus is replaced with a metal implant, and a plastic “cup” is inserted into the shoulder socket of the scapula. 

As the American Academy of Orthopedic Surgeons points out, patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for this procedure.

But patients who have osteoarthritis and a large rotator cuff tear that can’t be repaired by other methods, may find that traditional shoulder replacement may not be as effective. They may continue to have pain when they try to use their shoulder because of the poor condition of the rotator cuff muscles. Instead, those patients may benefit from a newer procedure called reverse shoulder replacement.

What is a reverse shoulder replacement?

Granted FDA approval in 2004, reverse shoulder replacement is done by “reversing” the implants.  This means attaching the metal ball implant to the shoulder socket and fixing the plastic socket to the end of the arm bone — the exact opposite of the traditional method.

Reverse shoulder replacement allows the shoulder joint to function using the deltoid muscles instead of relying oh the damaged rotator cuff muscles. The “delts” are the triangular muscles that form the rounded outer area on the upper arm.

Deciding who is a good candidate for shoulder replacement or reverse shoulder replacement requires the skill and knowledge of an experienced orthopedic surgeon, one who remains current with the latest technology. If you are having shoulder pain and would benefit from a consultation, call Dr. John Kagan at 239-936-6778 or go to

Shoulder Resurfacing: An Alternative, Bone-Conserving Technique

For younger, active adults with osteoarthritis of the shoulder, a procedure called a shoulder resurfacing may be a good alterative to total joint replacement. Shoulder resurfacing is considered an innovative bone-sparing procedure. Rather than replacing the entire joint, the goal of resurfacing is to “cap over” the damaged area and conserve as much of the bone and surrounding tissue as possible.

Another advantage of resurfacing is that patients can still undergo a total shoulder replacement at a later date if their osteoarthritis continues to do further damage to the cartilage and bone.

While the technique is still relatively new and is not appropriate for all patients, a 2010 study in the Journal of the American Academy of Orthopedic Surgeons, noted that “most patients were very satisfied with the result and 85 percent were able to return to sports at their desired level of participation.”

Shoulder Anatomy

The shoulder joint is actually comprised of two joints. The glenohumeral joint is where the humerus, or upper arm bone, and the glenoid, or socket meets. The acromioclavicular joint is where the shoulder blade and collarbone meet. If the glenoid is still healthy, with an intact cartilage surface and there are no fractures of the humerus, shoulder resurfacing is an option.

During the procedure, the surgeon shaves down the rough, worn-out joint surface of the humeral head and covers it with a new, smooth metal covering that allows the joint to glide smoothly without friction or pain.  

After the procedure, patients may remain overnight at the hospital or go home the same day.  Physical therapy is usually prescribed to help patients regain strength and full range of motion.

If you are suffering from chronic shoulder pain due to osteoarthritis, find out if you may be a candidate for shoulder resurfacing. Call 239-936-6778 to schedule a consultation or go to for additional information.

What is Shoulder Arthroscopy?

If you’ve been having pain or stiffness in your shoulder and your physician recommends arthroscopy, what can you expect? First introduced in the 1970s, arthroscopy is a way of looking inside the shoulder joint without the surgeon making a large incision. It is considered a minimally invasive procedure, which means that there is less trauma to the body, less blood loss and quicker recovery with patients going home the same day as the procedure.

According to the American Academy of Orthopedic Surgeons, the word arthroscopy comes from two Greek words – “arthro or joint and skopein or to look.” A small scope is inserted through a tiny incision in the shoulder into the joint. A mini-camera on the end of the scope transmits images back to a large video monitor in the operating room. The surgeon can look at the monitor and see inside the joint to determine the source of pain and decide how to treat it. Arthroscopy is used for both diagnosis and repair.

To repair damage in the cartilage, bones, tendons or ligaments, the surgeon will make several additional small incisions. Tiny, specially designed surgical instruments are inserted through the incisions and into the joint. Using the instruments, the surgeon can suture torn tissue, remove or shave cartilage and bone spurs, and implant metal or plastic parts joint to aid in stabilizing the joint.

For more information about arthroscopy, go to

What Does Minimally Invasive Surgery Mean?

Minimally invasive surgery is a newer technique that orthopedic surgeons use to diagnose and treat a wide variety of orthopedic-related conditions that can affect the knees, hips, shoulder, ankles and elbows.

Also called arthroscopic surgery and sometimes “keyhole” surgery, minimally invasive surgery has become the preferred choice and standard of care whenever possible due to the many benefits it offers to both the surgeon and the patient, including:

• Small incision size
• Less damage to the tissue
• Less blood loss
• Reduced post-operative pain
• Faster recovery
• Smaller scars
• The potential to go home the same day as the surgery

In contrast with traditional surgery, in which a large incision is used to open the body, with minimally invasive techniques, only tiny incisions – often described as “keyhole” size are required. This shift toward less invasive methods of diagnosing and treating injury and illness represents a major improvement in patient care.

What are some of the orthopedic-related procedures that can be performed with minimally invasive techniques? Removal of bone chips and spurs, damaged cartilage, and inflamed synovial fluid. Repairing ligament tears, bone fractures and tears to the meniscus and ACL. Treatment of shoulder dislocation, instability and rotator cuff tears. Even joint replacement surgery is often performed using minimally invasive techniques.

If you would like to learn more about minimally invasive orthopedic surgery, go to or call 239-936-6778.

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