- AC Joint & Bicep Injuries
- Arthroscopic Surgery
- Bankart Repairs
- Dislocation / Subluxation Repairs
- Labral Repairs
- Rotator Cuff Repairs
- SLAP Repairs
- Patient Education – Animated Procedures & Conditions
AC Joint & Biceps Injuries
AC Joint Injuries
The acromioclavicular (AC) joint is the meeting point of the acromion and clavicle bones, often indicated with a visible bump in the area. AC joint injuries often occur as a result of a fall or other trauma, which may cause the acromion to move or separate from the clavicle, or cause the ligaments to be stretched or torn.
While conservative treatment is often used first for AC joint injuries, surgery may be required for injuries that are more severe or those that cause prolonged pain. Surgery for AC joint injuries may involve removing the end or restoring the position of the clavicle to relieve pain and allow the patient to resume normal functioning of the joint.
Tendon injuries in the upper extremities are common in the biceps tendon, located at the upper end of the muscle where it attaches to the shoulder. This tendon can easily be damaged as a result of a sudden impact, overuse or age, which may cause the tendon to become inflamed or to tear in more severe cases. Patients with biceps tendon rupture often experience bruising, deformity, pain and weakness with movement. You may notice a popping sound if the tendon tears completely.
Treatment for a biceps tendon injury often includes a period of rest and immobilization, as well as applying ice and taking anti-inflammatory medication. Complete tears, or those that do not heal with conservative treatment, may require surgery to fuse the tendon back down to the bone and relive symptoms.
Arthroscopy is a minimally invasive surgical technique that involves several small incisions into which a fiber-optic device (arthroscope) and tiny surgical instruments are inserted. Orthopedic surgeons can diagnose and treat many different shoulder conditions with arthroscopy, while patients can benefit from less tissue damage, shorter recovery times, less scarring and less post-operative pain. This technique also avoids cutting any muscles or tendons in order to gain access to the affected area.
Shoulder arthroscopy is often performed to confirm a diagnosis after a physical examination and other imaging procedures have been performed. Some conditions can also be treated during the same procedure by inserting a few additional instruments into the joint area.
A Bankart lesion involves a labral tear to the inferior glenohumeral ligament. This injury occurs as a result of a shoulder dislocation, the force of which can often tear the labrum, especially in younger patients.
Successful treatment of some Bankart lesions can be achieved through conservative methods such as rest, immobilization and physical therapy. More severe cases may require surgery to reattach the torn labrum to the socket of the shoulder. This procedure is usually successful for most patients, allowing them to return to regular activities with little to no incidence of recurring dislocation. Surgery to repair a Bankart lesion can often be performed through arthroscopy.
Dislocation / Subluxation Repairs
The shoulder is a very fragile joint due to its complex nature and extremely versatile movements. This flexibility can work against the shoulder in cases such as dislocation, where the shoulder’s “ball-and-socket” composition allows the joint to literally disengage itself under stressful conditions. In many cases, the patient cannot move their upper arm at all after the injury.
A shoulder dislocation (also known as subluxation) is a very painful injury that also causes a significant amount of instability in the joint. If a dislocation is ever suspected, immediate medical attention is highly advised. The vast majority of shoulder dislocations are displaced towards the anterior direction of the body.
The treatment for shoulder dislocation is to relocate the humerus to its original position. This is accomplished through the process of closed reduction, where the arm is manipulated in such a way that, with proper applied force, it will “pop” back into place. These injuries are often treated in a conservative manner, however; if a severe rotator cuff or labral injury occurs, surgical repair may be necessary.
A labrum is a protective cuff of cartilage found in the shoulder that provides stability, cushioning and a full range of motion. A tear in the labrum, known as a labral tear, is caused by injury or overuse and can lead to pain and “catching” of the joint while moving. While many labral tears can be treated by managing pain symptoms and undergoing physical therapy, some cases require surgical treatment.
Labral repair aims to repair unstable shoulders with staples, anchors or sutures. It is usually performed using arthroscopy, which allows the surgeon to view the tear through a small camera and perform the procedure through tiny incisions. Larger tears may require an open procedure.
Rotator Cuff Repairs
The rotator cuff is a group of tendons and muscles that support the shoulder joint and allow for complete movement while keeping the ball of the arm bone in the shoulder socket. These tendons and muscles may become torn or otherwise damaged from injury or overuse and can lead to pain, weakness and inflammation. Surgery is often needed to treat this serious condition.
Rotator cuff surgery may be performed arthroscopically or through an open procedure, depending on the type and severity of the condition. Both procedures are performed under general anesthesia and aim to reattach the tendon back to the arm, along with removing any loose fragments from the shoulder area.
Although the shoulder is considered a “ball-and-socket” joint, the glenoid fossa “socket” covers less than one third of the humeral head “ball” at any one time. This tissue, known as the glenoid labrum, is formed by the cartilaginous extensions of the biceps origin.
This area is vulnerable to a specific injury known as a Superior Labral tear/lesion from Anterior to Posterior. This is similar to a Bankart lesion, except in this case the biceps tendon is not fully separated from the labrum. The SLAP tear is prevalent in high performance throwing athletes, such as baseball pitchers.
Patients with a SLAP lesion typically have limited range of motion in their shoulder and experience pain when moving the joint. The patient may also suffer from persistent dislocating and “catching” sensations when trying to move.
Surgery for a SLAP lesion is relatively quick, lasting less than two hours in most cases, and is done in a minimally invasive manner, utilizing an arthroscope to reduce the chance of infection and recovery time. Both the labrum and glenoid are abraded slightly to increase their surface areas and promote growth.
Patient Education – Animated Procedures & Conditions
Click on a topic below to learn more and view an educational animation.
- Arthroscopic Acromioclavicular (AC) Joint Separation Repair
- Arthroscopic Bankart Repair
- Diagnostic Arthroscopy (Shoulder)
- Distal Clavicle Excision (Resection)
- HemiCap® Resurfacing
- ORIF Surgery for Proximal Humerus Fracture
- SLAP Repair
- Total Shoulder Replacement
- Ultrasound-Guided Injection for Shoulder Pain
This surgical procedure is used to repair a severe separation of the acromioclavicular (AC) joint in the shoulder. In this procedure, torn or ruptured ligaments are brought together and a surgical screw or heavy suture is inserted through the clavicle and into a part of the scapula to hold the joint in place during healing. » Watch the animation
This arthroscopic procedure is used to repair a detached labrum. The labrum is a thick band of cartilage attached to the glenoid. It lines the shoulder socket and helps keep the ball of the humerus in place. » Watch the animation
This outpatient procedure is a minimally-invasive surgical technique commonly used to identify problems in the shoulder joint. It is performed with the aid of a specialized camera called an arthroscope. » Watch the animation
This minimally-invasive procedure helps to relieve pain and loss of motion in the shoulder from arthritis or impingement. During the procedure the end of the clavicle closest to the acromion in the shoulder is removed to allow pain-free movement of the joint. » Watch the animation
This procedure uses a small, metal, cap-like implant to cover damaged or missing articular cartilage in the shoulder joint. Articular cartilage covers the joint surfaces of bones, allowing them to glide smoothly against each other. In the shoulder, arthritis or an injury may result in loss or damage of the cartilage on the round humeral head, causing pain and limited motion. Resurfacing this damaged area can help relieve pain and improve motion. » Watch the animation
This surgical procedure repairs a break in the proximal end of the humerus. ORIF stands for Open Reduction Internal Fixation. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals. » Watch the animation
This arthroscopic procedure is performed to repair a tear of the biceps tendon at the point where it connects to the labrum, a ring of cartilage that surrounds the shoulder socket. A tear at this point is called a SLAP (Superior Labrum Anterior-Posterior) tear. SLAP repair is performed under general and regional anesthesia, and patients usually leave the hospital the same day. » Watch the animation
This surgery replaces the damaged or diseased head of the humerus (also called the ball) and cartilage from the shoulder joint with a metal and plastic joint. » Watch the animation
This non-operative, outpatient procedure is designed to provide relief for patients with pain in the shoulder from conditions such as osteoarthritis, rheumatoid arthritis and adhesive capsulitis. The technique allows the physician to inject an inflammation-reducing steroid with maximum accuracy. » Watch the animation
- Acromioclavicular (AC) Joint Arthritis
- Biceps Tendon Rupture
- Frozen Shoulder (Adhesive Capsulitis)
- Glenoid Labrum Tears
- Loose Shoulder (Multidirectional Instability)
- Proximal Humerus Fracture (Broken Shoulder)
- Rotator Cuff Injuries
- Rotator Cuff Tears
- Shoulder Arthritis
- Shoulder Dislocations
- SLAP Tear (Superior Labrum from Anterior to Posterior Tear)
This condition, also called AC joint arthrosis, is a degeneration of the joint at the top of the shoulder where the acromion meets the clavicle. » Watch the animation
This condition is a tear of one of the tendons that anchor the biceps muscle to the shoulder. The upper end of the biceps muscle is divided into two separate sections called the long head and the short head. The long head passes over the head of the humerus and attaches to the glenoid. The short head passes in front of the humerus and attaches to a bony protrusion, called the coracoid, on the shoulder blade. » Watch the animation
This condition is a loss of motion or stiffness in the shoulder, usually accompanied by pain in the joint. Frozen shoulder is most common in people between the ages of 40 and 60, but can afflict anyone regardless of gender, arm preference or occupation. » Watch the animation
This injury is a tear of the labrum, a thick band of cartilage that lines the rim of the glenoid (which is commonly called the shoulder socket). The labrum cushions the head of the humerus and holds it securely to the glenoid, stabilizing the joint. » Watch the animation
This condition occurs when the tissue that forms a capsule around the shoulder joint stretches and can no longer effectively keep the ball of the humerus within the shoulder socket. Patients with loose shoulder may experience frequent shoulder dislocations. » Watch the animation
This condition is a fracture of the head of the humerus – the “ball” of the shoulder’s ball-and-socket. » Watch the animation
The rotator cuff is a group of muscles and tendons that cover the head of the humerus and hold it in the shoulder socket. When rotator cuff tendons become damaged, the shoulder can become stiff, sore or lose mobility. Injuries are often caused by direct damage, such as a traumatic fall or repetitive overhead motions. It can also develop because of indirect causes such as impingement or shoulder imbalance. » Watch the animation
The rotator cuff is a group of muscles and tendons that cover the head of the humerus and hold it securely inside the shoulder socket. The cuff helps maintain joint stability while allowing the arm to lift and rotate. A tear of the rotator cuff can be painful and can interfere with shoulder movement. Four muscles make up the cuff: the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. » Watch the animation
Arthritis (also called osteoarthritis or degenerative arthritis) involves the swelling and damage of the joint. The condition causes pain and stiffness and limits shoulder joint movement. Causes of degeneration include increased age, everyday use of the joint, repetitive overhead movements, injuries such as fractures or chronic rotator cuff tears, or infection. » Watch the animation
This condition occurs when the head of the upper arm bone, the humerus, slips out of the socket formed by the scapula at the shoulder joint. Because the shoulder is not as stable as other joints, this injury is common. » Watch the animation
This condition is a tear of the labrum in the shoulder joint. The labrum is a ring of cartilage around the shoulder socket that stabilizes the head of the humerus. A SLAP tear occurs at the point where the biceps tendon attaches to the labrum. » Watch the animation