Frequently Asked Questions

How does the shoulder work?
The shoulder is a ball-socket joint made up of three bones: the humerus (upper arm bone), clavicle (collarbone), and scapula (shoulder blade). Smooth movement of this joint is made possible through a thin inner lining referred to as synovium. The head of the arm bones is lined with articular cartilage to allow for smooth mobility. A thin sheet of fibers known as the joint capsule surrounds the shoulder joint, providing stability and the full range of motion. The shoulder blade is attached to the upper arm via a group of tendons and muscles called the rotator cuff. Between the rotator cuff and shoulder blade is a lubricating membrane known as the bursa sac. This provides cushioning to the joints and bones. The shoulder blade itself attaches to the collarbone by the acromioclavicular (AC) joint. The collarbone then extends to the breastbone, attached by the sternoclavicular joint.

Who qualifies for shoulder surgery?
Typically, non-surgical treatment options are recommended as an alternative to surgical intervention. Specifically tailored physical therapy, ice compressions in conjunction with rest, personalized exercises, activity modification, and non-prescribed medication such as ibuprofen and aspirin are often effective alternatives. However, in certain instances, surgery may be necessary to prevent further degeneration and restore full mobility and use.

What is shoulder surgery used to treat?
Shoulder surgery may be used to treat any of the following diseases, injuries, and conditions: arthritis, recurrent dislocation, tendonitis, torn or degenerated cartilage, rotator cuff tears, fractures of the humorous or clavicle bones, capsulitis (stiffness or frozenness of the shoulder joint) chronic injury or degeneration, bursitis (inflammation of the bursa sac) or instability due to sudden injury or overuse of the ligaments in the shoulder.

What types of shoulder surgery are there?
There are three primary approaches to shoulder surgery:

Minimally Invasive/Arthroscopic Surgery: This approach involves the use of tiny incisions through which the surgeon inserts a tiny camera referred to as an arthroscope. The surgeon is then able to view the interior of the surgical site on screen. Tiny surgical instrumentation is inserted in conjunction with the camera, allowing the surgeon to perform procedures without major cutting of skin, muscle, and tissue. Recovery time is often faster, while pain and risk of complications are reduced due to less damage to surrounding tissue.

Mini-Open Surgery:  Similar to non-invasive surgery, this method utilizes arthroscopic equipment inserted through an incision approximately one to two inches in length. While it is not as minimalist as non-invasive surgery, this method allows for more extensive damage repair, without the extent of injury involved in open surgery. Muscles remain attached during this type of procedure, resulting in a faster recovery period.

Open Surgery: This method may require a large incision in the shoulder, however can often be achieved using smaller incisions. This permits the surgeon to increase access to the area, allowing the full extent of tissue repair to be performed. This method is sometimes associated with improved results.

What type of anesthesia will be used?
Surgery typically requires one of two types of anesthesia, often used in combination with each other:

Regional Anesthesia: Often referred to as a nerve block, this type of anesthesia is injected into nerves surrounding the surgical site. Sedation is often used in combination with regional anesthesia to ensure relaxation and comfort. Regional anesthesia is often used during arthroscopic procedures.

General Anesthesia: This type of anesthesia requires the intravenous administration of anesthesia in conjunction with inhaled gases resulting in a state of total unconsciousness. This prevents any pain or discomfort during the procedure. An anesthesiologist will be present to determine the correct dosage and types of anesthesia based on your physicality and medical history, as well as monitor your vital functions.

What will recovery be like?
The length and extent of recovery will be dependent on several factors including the type of procedure performed, the age and physicality of the patient before surgery, and patient compliance with a post-surgery treatment plan. Recovery after surgery often requires a post-surgical evaluation as well as a collaborative treatment plan. Physical therapy may also be required. Swelling, pain, and numbness may be present after surgery. Your doctor will prescribe pain medication. It is wise to begin taking this before experiencing any discomfort. Generally, recovery takes approximately 6-12 weeks.

What should I expect before surgery?
Before surgery, you will be asked to abstain from any food or drink after midnight. Your doctor will also discuss your medical history and any medications or supplements you may be taking.