Shoulder

Shoulder Anatomy

Shoulder Anatomy

The shoulder is the most flexible joint in the body enabling a wide range of movements including, forward flexion, abduction, adduction, external rotation, internal rotation, and 360-degree circumduction.

Thus, the shoulder joint is considered the most insecure joint of the body but the support of ligaments, muscles and tendons function to provide the required stability.

Conditions

Calcific Cuff Tendinopathy

Calcific cuff tendinopathy is a problem with the shoulder’s tendons and muscles. This condition occurs due to the formation of calcium deposits in the tendons (tissue which attaches muscle to bone) of the rotator cuff (group of muscles and tendons stabilising the shoulder). This calcium build-up causes inflammation of the tissues surrounding it, and intense shoulder pain. The space between the rotator cuff and the acromion (outer bony end of the shoulder blade) is also reduced due to the calcium deposits, affecting the normal functioning of the rotator cuff.

Rotator Cuff Tear

Rotator Cuff Tear

Rotator cuff is the group of tendons in the shoulder joint providing support and enabling wider range of motion. Major injury to these tendons may result in tear of these tendons and the condition is called as rotator cuff tear. It is one of the most common causes of shoulder pain in middle aged adults and older individuals.

Shoulder Pain

Shoulder Pain

Pain in the shoulder suggests a shoulder injury which is more common in athletes participating in sports such as swimming, tennis, pitching and weightlifting. The injuries are caused due to the over usage or repetitive motion of the arms.

Subluxation

The shoulder is a highly mobile ball and socket joint. The ball of the upper arm bone (humerus) is held in place at the socket (glenoid) of the shoulder blade (scapula) by a group of ligaments. A partial dislocation of the shoulder joint is termed as a subluxation. This means the ball has partially moved out of the glenoid as opposed to a dislocation, where the ball completely moves out of the glenoid. Subluxation usually occurs from falls or a direct blow to your shoulder.

Shoulder Impingement

Shoulder Impingement

Shoulder impingement is the condition of inflammation of the tendons of the shoulder joint. It is one of the most common causes of pain in the adult shoulder. The shoulder is a 'ball-and-socket' joint. A ‘ball' at the top of the upper arm bone, humerus, fits neatly into a 'socket’, called the glenoid, which is part of the shoulder blade, scapula. Shoulder impingement is also called as swimmer’s shoulder, tennis shoulder, or rotator cuff tendinitis.

SLAP Tears

SLAP Tears

The shoulder joint is a ball and socket joint. A 'ball' at the top of the upper arm bone (the humerus) fits neatly into a 'socket', called the glenoid, which is part of the shoulder blade (scapula). The term SLAP (superior –labrum anterior-posterior) lesion or SLAP tear refers to an injury of the superior labrum of the shoulder.

Arthritis of the Shoulder

Arthritis of the Shoulder

The term arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. Damage of the cartilage in the shoulder joint causes shoulder arthritis. Inflammation is the body's natural response to injury. The warning signs that inflammation presents are redness, swelling, heat and pain.

Frozen Shoulder

Frozen Shoulder

Frozen shoulder, also called adhesive capsulitis is a condition characterized by pain and loss of motion in shoulder joint. It is more common in older adults aged between 40 and 60 years and is more common in women than men.

Shoulder Instability

Shoulder Instability

Shoulder instability is a chronic condition that causes frequent dislocations of the shoulder joint.

Shoulder Joint Tear

Shoulder Joint Tear

The shoulder joint is a “ball and socket” joint that enables the smooth gliding and thereby the movements of arms. However, it is inherently unstable because of the shallow socket. A soft rim of cartilage, the labrum lines the socket and deepens it so that it accommodates the head of the upper arm bone better.

Dislocated Shoulder

Dislocated Shoulder

Playing more overhead sports activities and repeated use of shoulder at workplace may lead to sliding of the upper arm bone, the ball portion, from the glenoid–the socket portion of the shoulder. The dislocation might be a partial dislocation (subluxation) or a complete dislocation causing pain and shoulder joint instability.

Little League Shoulder

Little league shoulder is an injury to the growth plate of the upper arm bone in the shoulder joint of children. It is caused due to overuse from pitching or throwing, especially in children between the ages of 10 to 15 years.

Bicep Tendon Rupture

Bicep Tendon Rupture

The biceps tendon is a tough band of connective fibrous tissue that attaches your biceps muscle to the bones in your shoulder on one side and the elbow on the other side.

A Biceps tendon rupture can either be partial, where it does not completely tear the tendon, or complete, where the biceps tendon completely splits in two and is torn away from the bone.

Burners & Stingers

Burners and stingers are common neck or shoulder injuries characterized by intense burning or stinging pain which can radiate from the neck to the hand. They are caused by sudden movement or a direct blow to the neck resulting in an injury to the brachial plexus.

Fractures/ Injuries

Shoulder Trauma

Shoulder injuries most commonly occur in athletes participating in sports such as swimming, tennis, pitching, and weightlifting. The injuries are caused due to the over usage or repetitive motion of the arms.

Clavicle Fracture

Clavicle Fracture

Clavicle fracture, also called broken collarbone is a very common sports injury seen in people who are involved in contact sports such as football and martial arts as well as impact sports such as motor racing. A direct blow over the shoulder that may occur during a fall on an outstretched arm or a motor vehicle accident may cause the clavicle bone to break.

Fracture of the Shoulder Blade

Fracture of the Shoulder Blade

The scapula (shoulder blade) is a flat, triangular bone providing attachment to the muscles of the back, neck, chest and arm. The scapula has a body, neck and spine portion.

Scapular fractures are uncommon but do occur and require a large amount of force to fracture.

Distal Humerus Fractures of the Elbow

Distal Humerus Fractures of the Elbow

The elbow joint is very important for the movement of your arms and for coordination of daily activities. Injury in the distal humerus can cause impairment in the function of the elbow joint. Distal humerus fracture is a rare condition which occurs when there is break in the lower end of the humerus.

Glenoid Fractures

The glenoid is the socket that forms the ball and socket joint of the shoulder. Fractures of the glenoid are rare but can occur due to major trauma or during high-energy sports activities.

Baseball & Shoulder Injuries

Shoulder injuries in baseball players are usually associated with pitching. While this overhand throwing activity can produce great speed and distance for the ball, when performed repeatedly, it can place a lot of stress on the shoulder.

Procedures

Suprascapular Nerve block & ablation

Suprascapular nerveis a mixed (sensory and motor) nerve that arises from the upper trunk of the brachial plexus. The nerve travels through the suprascapular notch beneath the superior transverse scapular ligament (STSL) of the shoulder and supplies the supraspinatus and infraspinatus muscles.

Acellular Dermal Matrix Reconstruction of Rotator Cuff (Graft Jacket)

Graft jacket is a regenerative tissue product developed from human skin (consisting of collagen and elastic fibres) and is used for initiating the process of regrowth of damaged tissue.

PRP injections for Tennis/ Golfer’s elbow

PRP is a relatively new method of treatment for several orthopaedic conditions such as muscle, ligament, and tendon injuries; arthritis; and fractures. PRP injections can help alleviate painful symptoms, promote healing and delay joint replacement surgeries.

Rotator cuff repair

Rotator Cuff Repair

Rotator cuff is the group of tendons in the shoulder joint providing support and enabling wider range of motion. Major injury to these tendons may result in tear of these tendons and the condition is called as rotator cuff tear. It is one of the most common causes of shoulder pain in middle aged adults and older individuals.

Shoulder Injections

Shoulder Injections

Injection of a pain medication in combination with a local anaesthetic directly to the site of injury helps to relieve pain. The advanced imaging of ultrasound provides high resolution images that enable the physician to precisely locate the injections deep into the target tissue without harming surrounding tissues.

Shoulder Joint Replacement

Shoulder Joint Replacement

When the cartilage is damaged, the two bones rub against each other resulting in pain, swelling and stiffness of the joint (osteoarthritis).

Total shoulder replacement surgery is performed to relieve these symptoms. In this surgery, the damaged articulating parts of the shoulder joint are removed and replaced with artificial prostheses.

Partial Shoulder Replacement

Partial shoulder replacement, also called shoulder hemiarthroplasty is a surgical procedure during which the upper bone in the arm (humerus) is replaced with a prosthetic metal implant, whereas the other half of the shoulder joint (glenoid or socket) is left intact.

Reverse Shoulder Replacement

Reverse Shoulder Replacement

Reverse total shoulder replacement, is an advanced surgical technique specifically designed for rotator cuff tear arthropathy, a condition where the patient suffers from both shoulder arthritis and a rotator cuff tear.

Revision Shoulder Replacement

Revision Shoulder Replacement

Revision surgery is usually performed under general anaesthesia. You are positioned to allow all possible variations in the treatment plan. Incisions are made to gain optimal access to the problem, and usually follow previous incisions with extensions made as necessary. Revision involves removing any impeding structures such as scar tissue. Muscles, tendons and ligaments that are stiff are released to improve range of motion and those that are injured are repaired using tendon grafts.

Shoulder Hydrodilatation

Hydrodilatation is one of the latest techniques for treatment of frozen shoulder or adhesive capsulitis. Adhesive capsulitis or frozen shoulder is a condition characterized by the contraction and inflammation of the joint capsule surrounding the shoulder joint. This is associated with pain, stiffness and loss of range of motion in the shoulder joint. Hydrodilatation is performed to decrease the pain and improve the mobility of the shoulder joint.

Minimally Invasive Shoulder Joint Replacement

Minimally Invasive Shoulder Joint Replacement

Shoulder joint replacement is a surgical procedure to replace damaged bone surfaces with artificial components to relieve pain and improve functional ability in the shoulder joint. Shoulder joint replacement can be done by a traditional "open" approach or through a minimally invasive approach. The incision in minimally invasive shoulder joint replacement is about 5 cm compared to 17 cm with the traditional approach.

Arthroscopic Rotator Cuff Repair

Arthroscopic Rotator Cuff Repair

Rotator cuff is the group of tendons in the shoulder joint providing support and enabling wider range of motion. Major injury to these tendons may result in tear of these tendons and the condition is called as rotator cuff tear. It is one of the most common causes of shoulder pain in middle aged adults and older individuals. It may occur with repeated use of arm for overhead activities, while playing sports or during motor accidents. Rotator cuff tear causes severe pain, weakness of the arm, and crackling sensation on moving shoulder in certain positions. There may be stiffness, swelling, loss of movements, and tenderness in the front of the shoulder.

Arthroscopic Biceps Tenodesis

Arthroscopic Biceps Tenodesis

The biceps is a large skeletal muscle of the upper arm that flexes the elbow to lift the forearm, and is also responsible for some shoulder movements. It is connected by tendons to bones in the shoulder and elbow on either side. Injury of the biceps tendon in the region of the shoulder can occur due to disease, overuse or repetitive overhead activity, leading to pain and weakness in front of the shoulder and down the upper arm. This may be treated conservatively, but in severe cases a surgical procedure called biceps tenodesis may be performed to repair the biceps and alleviate symptoms. A biceps tenodesis is recommended to treat biceps tendon tears, inflammation or instability accompanied by injury to the rotator cuff muscles that surround and support the shoulder joint.

Arthroscopic Bankart Repair

Arthroscopic Bankart Repair

The shoulder joint (glenohumeral joint) is a ball and socket joint, where the head of the upper arm bone (humerus) attaches to the shoulder socket (glenoid cavity). The shoulder socket is extremely shallow and therefore needs additional support to keep the shoulder bones from dislocating. The labrum, a cuff of cartilage that encircles the shoulder socket, helps serve this purpose by forming a cup for the humeral head to move within. It provides stability to the joint, enabling a wide range of movements.

Arthroscopic Acromioclavicular Joint Reconstruction

Acromioclavicular joint (AC joint) dislocation or shoulder separation is one of the most common injuries of the upper arm. It involves separation of the AC joint and injury to the ligaments that support the joint. The AC joint forms where the clavicle (collarbone) meets the shoulder blade (acromion).

Shoulder Labrum Reconstruction

The shoulder joint is a ball and socket joint. A 'ball' at the top of the upper arm bone (the humerus) fits neatly into a 'socket', called the glenoid, which is part of the shoulder blade (scapula). The labrum is a ring of fibrous cartilage surrounding the glenoid which helps in stabilizing the shoulder joint. The biceps tendon is attached inside the shoulder joint at the superior labrum of the joint. The biceps tendon is a long cord-like structure which attaches the biceps muscle to the shoulder and helps to stabilize the joint.

Shoulder Arthroscopy

Shoulder Arthroscopy

Arthroscopy is a minimally invasive diagnostic and surgical procedure performed for joint problems. Shoulder arthroscopy is performed using a pencil-sized instrument called an Arthroscope. The arthroscope consists of a light system and camera to project images to a computer screen for your surgeon to view the surgical site. Arthroscopy is used to treat disease conditions and injuries involving the bones, cartilage, tendons, ligaments, and muscles of the shoulder joint.

Arthroscopic Biologic Total Shoulder Resurfacing

Shoulder arthritis is an inflammatory condition causing pain and stiffness in the joint. It can be successfully treated with total joint replacement surgery which is commonly performed on older patients. However, the surgery is not advisable for young active individuals due to concerns with durability of the implants used in replacement surgery.