T2 L4: Surgery of the shoulder

Question 1

What are some subacromial problems of the shoulder?

Answer 1

Artharitis
Rotator cuff tears
Calcific tendonitis

Question 2

What is subacromial impingement?

Answer 2

When the acromion rubs against or pinches your rotator cuff beneath it, causing pain and irritation

Causes pain during abduction and rotation of arm. Felt over deltoid

Extrinsic cause: bone growth
Intrinsic cause: tendinopathy/ cuff weakness

Question 3

How is subacromial impingement treated?

Answer 3

Activity modification
Physiotherapy

Surgical:

• Subacromial decompression
• Debridement of bony and soft tissue impinging the areas

Question 4

Where are rotator cuff tears most common?

Answer 4

The supraspinatus and infraspinatus muscles

Question 5

What are some glenohumeral joint problems?

Answer 5

Arthritis:

• Osteoarthritis
• Rheumatoid arthritis
• Post-traumatic arthritis
• cuff tear arthritis

frozen shoulder
Instability

Question 6

What are some symptoms of shoulder arthritis?

Answer 6

• Stiffness
• Crepitus and grinding
• Pain at rest and at night
• Pain with activity

Question 7

What is crepitus?

Answer 7

A popping, clicking or crackling sound in a joint

Question 8

What are the 2 types of shoulder replacement?

Answer 8

Anatomic:
-The arthritic joints are resurfaced with metal and plastic
(Can’t be done if the shoulder is unstable)

Reversed:
-The ball and the socket are replaced. It creates a mechanical fulcrum

Question 9

What is frozen shoulder?

Answer 9

A glenohumeral joint problem also known as adhesive capsulitis

The joint capsule gets inflamed and causes stiffness

It’s idiopathic but can be traumatic

Question 10

What is the treatment for frozen shoulder?

Answer 10

Non-surgical:

• Naturally resolves over 2 years
• Injections
• Hydrodilatation

Surgical:
-Capsular release and manipulation