Frequently Asked
Questions
Orthopedics (alternatively, orthopaedics) is a medical specialty focused on the diagnosis and treatment of conditions, disorders, and injuries of the muscles, bones, joints, tendons, ligaments, and nerves.
A doctor who specializes in this medical specialty is called an orthopedic (alternatively, orthopaedic) surgeon or orthopedist.
Please click here to learn more about orthopedic surgeons and their training and specialization.
Arthritis in the shoulder refers to the inflammation and degeneration of the shoulder joint, resulting in pain, stiffness, and reduced range of motion. It is a common condition that can significantly impact daily activities and quality of life. The most prevalent form of arthritis in the shoulder is osteoarthritis. Osteoarthritis occurs when the protective cartilage that cushions the joints gradually wears away over time. As the cartilage deteriorates, the bones in the shoulder joint may rub against each other, leading to pain, swelling, stiffness, and a decreased range of motion.
Shoulder arthroscopy is a technique that repairs your shoulder joint making only small incisions. Arthroscopic surgery involves a tiny camera, called an arthroscope, which is inserted through a small incision close to the affected area. This camera allows us to see all the structures of your shoulder and perform repairs to multiple injuries during a single procedure.
The most important advice I have for patients recovering from rotator cuff repair surgery is to let the tendon fully heal before being aggressive with the shoulder. The tendon is healing, but it only reaches 30% of normal strength at the end of the six weeks. Studies show that half of the re-torn rotator cuffs occur between three- and six-months following surgery which is during the time when patients begin feeling good and overdo it.
As a shoulder specialist, I see patients who have not had ideal results after previous surgery elsewhere, and a common theme is that they advanced their exercises too early during the slow tendon healing process. My favorite advice for my patients is to be conservative early so you can be aggressive later.
Determining if your shoulder pain requires surgical intervention is best done through a comprehensive evaluation by an orthopedic surgeon specializing in shoulder care, like the Denver Shoulder team. However, there are certain signs and symptoms that may indicate the need for surgical intervention. Here are some factors to consider:
1. Severe and persistent pain after conversative treatments.
2. Loss of function limiting your ability to perform daily activities.
3. Structural abnormalities revealed during tests like x-rays, MRIs and CT scans.
4. Instability or frequent dislocation.
5. Fail non-surgical treatments over a period of time.
A regular shoulder replacement (or an Anatomic Shoulder Replacement) is typically recommended for patients with osteoarthritis, rheumatoid arthritis, or other degenerative conditions that primarily effect the shoulder joint itself. The artificial joint consist of a ball attached to the upper end of the humerus (arm bone) and a plastic socket implanted into the glenoid (shoulder socket). This surgery mimcs the normal anatomy of a shoulder.
A Reverse Total Shoulder Replacement is typically recommended for patients with a severe rotator cuff tear. This is usually a irreparable tear combined with arthritis of the shoulder joint. The ball ad socket components are reversed compared to the regular shoulder replacement. A ball is placed on the glenoid (shoulder socket) and a plastic socket is attached to the upper end of the humerus (arm bone). This surgery changes the mechanics of the shoulder where the deltoid muscle instead of the rotator cuff is relied on for power and stability of the shoulder. This allows for improved function even with a non-functional or severely damace rotator cuff.
There are a number of non-operative options for shoulder pain, depending on the underlying cause and severity of the condition. Common treatments include:
- Rest and activity modification
- Physical Therapy
- Pain medications
- Ice and heat therapy
- Steroid injections
- Assistive devices like slings