Shoulder Surgery.
Acromioplasty
Surgery may be required to treat a rotator cuff disorder. Bone is shaved or growths removed from the upper point of the shoulder blade: the goal is to remove roughness while keeping as much of the normal supporting structure as possible. This surgery creates more space so the rotator cuff tendon is not pinched or irritated and can glide smoothly beneath the acromion.
Subacromial smoothing, acromioplasty, is done using arthroscopic surgery. Arthroscopy uses an arthroscope inserted into a joint through a small incision in the skin. Additional instruments are inserted to remove loose fragments of tendon, bursa, and other debris from the shoulder.
Rotator Cuff Repair
To repair a torn rotator cuff, the damaged tendon or tendons are reattached to the upper arm. An incision is made in the shoulder, the surgeon cuts through the deltoid muscle and removes any scar tissue that has built up on the tendon, then the bone is prepared at the top of the upper arm. Small holes are drilled through the bone and the tendon is sewed to the bone, with the sutures going through an anchor in the upper arm bone.
The surgeon will also remove bone spurs and release any ligaments pressing on the tendon. If a bursa is inflamed, it will be removed. A small portion of the acromion will also be removed to ensure the repaired rotator cuff has room to move. (see Acromioplasty)
Labral Reconstruction
Arthroscopy may be used to reconstruct a labral lesion. Two to three small puncture incisions are used and, if possible, the torn tissue is reattached to the bone using small suture anchors. In cases where the labral tissue has not torn off the bony glenoid, the frayed tissue is shaved and smoothed down.
Joint Replacement
Shoulder replacement may be required to relieve severe arthritic pain in the shoulder joint or to fix severe physical joint damage. In shoulder replacement surgery, the painful surfaces of the damaged shoulder are resurfaced with artificial shoulder parts. A stem with a rounded metal head is used to replace the ball, while a smooth plastic concave shell replaces the socket (this matches the round head of the ball). Total shoulder replacement involves resurfacing both sides of the joint while partial replacement requires resurfacing only the humeral side of the joint (ball).