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Problems Related To The Shoulder

Written and reviewed by
MS - Orthopaedics, MNAMS (Membership of the National Academy) (General Surgery) , DNB (Orthopedics), MBBS
Orthopedic Doctor, Delhi  •  10 years experience
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Hi friends, 

 I am Dr. Sunny Chopra,Orthopedist.  Today we will discuss about the shoulder. We have seen many cases of shoulder age to age. Initial young age we having impingement syndrome of shoulder and rotator cuff tear, traumatic rotator cuff tear and recurrent dislocation of shoulder. Middle age we having a rotator cuff tear, frozen shoulder, bicep tonality, slap tear and old age we having a rotator cuff arthropathy and frozen shoulder and more towards the bursitis and complete rotator cuff arthropathy.

So, we having so much myth about the shoulder where we have to go, which doctor is for shoulder because all orthopaedic doctors are not able to cure the shoulder treatment. We are continuing giving the medicines, we continue giving the injection in the shoulders and all that. Many females are come to us which having difficulty in shoulder, she can't sleep over that shoulder, belna karne me dikkat hota hai, karchi ghumane me, kapde nichodne me, even unlid the open jar, screwing and unscrewing moments; these all leads to difficulty in daily day-to-day activity and all that. And also we are going to continue physiotherapy, physiotherapy then we apply the injections also. Patient we have relief for relief for 6 weeks, 8 weeks. Now the trend gets changed. We having a good armamentarium, we having a good approach towards the shoulder, we having a minimal invasive shoulder approach via shoulder arthroscopy and shoulder rehabilitation protocol. Patients they are more towards rehabilitation, physiotherapy; even the patient having a rotator cuff tear, even the patient having a so massive tear and he can't able to play sports like many patient who having a overthrow activity, basketball player, volleyball player they having a slap tear. So that scariness of the shoulder pathology has now from onwards is getting is totally disappear. We having a many patient we dealing with shoulder pathology, like this is a shoulder joint. We having this is rotator cuff, this is a bicep tendon, this is anterior sub-scapularis the whole they form the shoulder rotator cuff. So to minimally invasive technique to shoulder arthroscopy, we repair the rotator cuff using suture anchor, using radio frequency ablation.

We decompress that subacromial area, we capsule-optimize the capsule part. We put the patient under shoulder rehabilitation, through the biceps tenotomy also the patient get relief in old age. If the bicep get tear in young age we have to do biceps tenodesis also. And we have seen the many patient who having a recurrent dislocation, recurrent dislocation more than 20-30 dislocation shoulder in a year. So there is a pathology which is known as Benkart Lesion because when the first dislocation in the shoulder, the Benkart get torn up. So we repair the Benkart lesion using a suture anchor and through the shoulder arthroscopy.

We discharge the patient next day, 24 hours. There is no any muscle cut, no blood loss, no any complication rate as seen in the shoulder. Early rehabilitation, early physiotherapy, early mobilization the shoulder joint that makes more rehabilitation protocol easier as compared to if we are going directly physiotherapy and all that. Mind you if the patient having a rotator cuff tear and we put a injection or we put a patient on rehabilitation that creates more tear vastness and we create more increase in the tear as compared to if we do arthroscopical rotator cuff repair that leads to more sound towards the rehabilitation. Physiotherapy also get some more edge after the repair.

We acclimatize or we acro-plasty the acromion process which impinge the rotator cuff. We teno tenotomy the biceps which also put a pressure over that cuff area that rotator interval area and also in some cases we do the tenodesis also. We do the Benkart also. All the patient we discharge after 24 hours. We put the patient on shoulder rehabilitation up to 4-6 weeks. 2-3mm stitch dissolvable stitch we apply that and mind you the scariness and difficulty in shoulder treatment all get resolved from the shoulder arthroscopy. We just thanks to God almighty and well wishers. We are dealing with the shoulder arthroscopy, we are dealing with shoulder pathology, we are dealing with shoulder rehabilitation. Our patients initially 4 to 6 weeks after cuff repair patient having a pain for 2 to 3 weeks but good shoulder rehabilitation the patient get relief from that area.

Thanks.

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