DR. CHETAN WANKHEDE is Consultant Orthopaedic Surgeon and Shoulder Surgeon in Thane and Mumbai.

What is shoulder surgery?

Shoulder surgery treats injured shoulders by repairing the muscles, connective tissue, or damaged joints that occur from traumatic injury, or from where the shoulder has been overused.

Shoulder problems that require surgery

• Bursitis or tendinitis The rotator cuff can cause pain in many different ways, which includes tendonitis, bursitis or mechanical impingement. These are due to repetitive activities such as swimming or weightlifting. The repetition causes rubbing or squeezing of the rotator cuff under the acromion and in the acromioclavicular joint.
• Impingement This occurs when the top of the shoulder blade puts pressure on the underlying soft tissues when lifting the arm away from the body. Symptoms of impingement include difficulty reaching up behind the back, pain when using the arm over the head and weakness in shoulder muscles.
• Full-thickness rotator cuff tears Full-thickness rotator cuff tears are often the result of shoulder impingement, partial thickness rotator cuff tears or they can occur from heavy lifting and falls. Rotator cuff tears may involve the entire thickness of the tendon or they may be incomplete, which is known as partial thickness. Rotator cuff surgery and rehabilitation allows patients to regain the lost function in shoulders with cuff disease.
• Instability/Recurrent Dislocation of Shoulder One of the shoulder joints is forced out of its normal position. This condition can result in a dislocated shoulder. Patients will experience pain when they raise an arm and it may also feel like their shoulder is out of place.

Surgical treatment for shoulder injuries

All-arthroscopy repair – smaller incision is made for scope insertion and whole joint is visualised and then necessary repair is taken like Rotator cuff repair, Bankart repair, etc

What is rotator cuff surgery?

The rotator cuff is a group of tendons and muscles that keeps the upper arm bone (humerus) in the socket of the shoulder blade. Sometimes the rotator cuff can be torn which causes pain, limited motion and weakness. If the tear is particularly bad or non-surgical methods have failed to repair the rotator cuff, then surgery will be recommended.

Why would you need rotator cuff surgery?

Surgery is required if non-surgical methods have failed, or if the tear is very bad. Rotator cuff tears can be partial (just some of the tendon fibres are torn) or full (the tendon is completely torn). The rotator cuff can be torn when playing sports, such as tennis or cricket, or through physical activities, or through general wear and tear over time. Traumatic injury can also tear your rotator cuff as well.

What does rotator cuff surgery involve?

Rotator cuff surgery involves:

• Fragments of tendon and other debris are removed from the shoulder joint.
• Sometimes bone needs to be shaved down to allow for more room for the rotator cuff to move around without being pinched.
• The torn tendon is sewn together and to the top of the humerus.

Surgery can be performed either:

• By arthroscopy where an arthroscope is inserted through a small incision through which the surgery is performed using a video monitor.
• By mini open surgery, for more complicated tears. A larger incision is made and the muscle is carefully moved to the side to allow for the repair to be made.

What is Bankart lesion?

Due to Recurrent dislocation of shoulder there is injury of the anterior glenoidlabrum of shoulder and pocket form at the front of glenoid allowing had to dislocate into it.

What is Bankart repair?

It involves re-anchoring and suturing the torn piece of cartilage to restore security and stability of shoulder joint.This procedure is performed arthroscopically(key hole).

Post-operative care

Pain following surgery will be managed with rest and painkillers. You will wear a sling following surgery as well. Throughout recovery you will need to have physical therapy to ensure the rotator cuff heals properly. Movement exercises can begin as soon as a couple of days following surgery. After 6-8 weeks following surgery, active exercise with shoulder movement can be performed, depending on how bad the rotator cuff tear was. You can expect to return to regular activities after several months.