CONDITIONS & TREATMENTS
Based upon your condition, diagnosis and previous treatment, most conditions are treated initially with non-operative treatments that include rehabilitative services including physical therapy and exercises to help regain motion and strength in the shoulder. This is occasionally supplemented with medication, as required. However if non-operative treatment fails to address the issue, then surgical intervention may be an option.
- Fractures - A shoulder fracture can involve the proximal humerus, the scapula, or the clavicle. Many of these broken bones can be treated non-operatively as long as there is minimal displacement or movement of the bone fragments. If the bones are moved too far apart, then an operative intervention may be required to reduce the fracture and hold the bones in place using of internal fixation (plates and screws) while the bones heal. (Click here to see examples of Dr. Gupta's patients)
- Rotator cuff - The rotator cuff is a group of muscles and tendons that surround the shoulder joint to allow the humeral head to stay within the glenoid (socket) during shoulder motion. When a patient sustains an injury to the rotator cuff, the hope is that it will heal on its own if there is a partial thickness tear of the rotator cuff. Rehabilitative services help with strengthening of scapula-thoracic muscles while the rotator cuff is healing. Of course, full-thickness tears cannot heal on their own. How could they- if the tendon is off the bone, it cannot reattach to the bone (greater tuberosity of the proximal humerus) without a surgeon’s intervention. With that being said, not all rotator cuff tears require operative intervention. If your rotator cuff does need to be fixed, this can most often be performed with an arthroscopic procedure. This is a minimally invasive procedure in which a small camera is introduced into the shoulder joint to visualize the soft tissues while additional small incisions are made to pass instruments and repair the rotator cuff.
- Instability - Instability surgery can range from either arthroscopic (minimally invasive) to full open procedures such as a Latarjet procedure. These procedures are performed to help stabilize the shoulder after rehabilitative services fail to address the shoulder pain and feelings that the shoulder might dislocate.
- Adhesive capsulitis or frozen shoulder - This is a very challenging condition that unfortunately takes quite some time to heal. Fortunately, it is rare for patients to require an operation. Patients usually require gentle reassurance, focused rehabilitative services and intermittent steroid injections into the joint to help ameliorate the symptoms.
- Arthritis - Like all joints, the shoulder can be affected by degenerative changes. Degenerative changes cause the cartilage to wear away, so that the patient may be left with bone on bone at the joint. When a patient has this secondary to osteoarthritis, rheumatoid arthritis or posttraumatic arthritis, the condition can cause severe pain and disability. At this point, the patient can be considered for a shoulder replacement. There are many different types of shoulder replacements ranging from a hemi-arthroplasty to a total shoulder arthroplasty to a reverse total shoulder arthroplasty. Each of these is an option based upon the condition of your shoulder and the remaining tissue and structures that allow us to repair this. (Click here to see examples of Dr. Gupta's patients)