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)