Arthroscopy - Shoulder
Shoulder Recurrent Dislocation1. What is recurrent dislocation of shoulder?
Ans: Traumatic recurrent dislocation of shoulder is the frequent displacement of the humeral head out of glenoid surface. Dislocation of shoulder is mostly seen following injury to the shoulder for the first time. After that there is recurrence of shoulder dislocation in 40 % of cases within 2 years. When the frequency increases, then it is called recurrent dislocation of shoulder. Dislocation occurs either due to non-healing of the torn labrum or glenoid bone loss.2. How is recurrent dislocation of shoulder treated?
Ans: Dislocation due to labrum tear (Bankart lesion) is treated with arthroscopically assisted suture anchors. Dislocation due to glenoid bone loss is treated with Laterjet procedure which is an open or arthroscopic procedure.3. What will be the post-operative care?
Ans: Post surgery patient will be advised sling or shoulder immobiliser for 4-6 weeks and are advised for physiotherapy protocol. By 2-3 months can do normal daily activities. For sports, it takes 6-9 months.
Cuff tear1. What is cuff tear?
Ans: There are four muscles which form cuff around the shoulder joint. These muscles help in elevation & rotation of the arm and stabilising the shoulder joint. When there is tear in these muscles or there attachment over humeral head, it is called rotator cuff tear.2. How is rotator cuff tear diagnosed?
Ans: cuff tear can be diagnosed with clinical examination and confirmed by MRI scan.3. How is a cuff tear treated?
Ans: Rotator cuff tear is repaired by arthroscopy assisted suture anchors. It can also be repaired by mini open surgery.4. What happens if cuff is not repaired?
Ans: The affected person will have difficulty in lifting weights and pain in shoulder. Later it may lead to cuff arthropathy i.e arthritis of the shoulder joint.5. how much will be the recovery time?
Ans: Post surgery the person will have shoulder immobiliser for 1 month and then will have to follow physio protocol. Will be able to do daily activities by 2-3 months and strenuous activities and sports by 9 months to 1 year.
FROZEN SHOULDER1.What is Frozen shoulder?
Ans: Frozen shoulder is also known as adhesive capsulitis. It is condition where the capsule surrounding the shoulder joint becomes inflammed and later contracts leading to painful restriction of movements of the shoulder.
Frozen shouldet or adhesive capsulitis has 4 phases of disease progression.
It is a self-limiting disease with a prolonged duration of upto 2 years.2.Who are most commonly affected by this condition?
Ans:Elderly people with diabetes, hypothyroid, post cardiac surgery are most commonly but it can affect anyone.3. How is frozen shoulder treated?
Ans: First phase is treated with anti-inflammatory medications and physiotherapy
Second and third phase are treated with physiotherapy first then if no response – manipulation under anaesthesia with or without arthroscopic capsule release depending on the bone quality.
Post manipulation, patient has to continue physiotherapy.
Arthroscopic release is required with long standing frozen shoulder with osteoporosis.