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Shoulder Services Provided

The Shoulder Center offers patients advanced technologies in the diagnosis, management and treatment of shoulder conditions and shoulder pain. We take a multidisciplinary approach to care in order to minimize pain and quickly restore function. Most surgeries, whether arthroscopic rotator cuff repair or full shoulder replacement surgery, require approximately 30-45 minutes (often less) of surgical time.  Some of the services that we provide are:

  • Shoulder Diagnosis and Nonoperative Management
  • Shoulder Ultrasound Evaluation
  • Shoulder Surgery
  • Shoulder Arthroscopy
  • Shoulder Sports Injuries
  • Shoulder Fractures
  • Rotator Cuff Repair
  • Instability and Labral Surgery
  • Biceps Labral and Biceps Pulley Injuries
  • Total Shoulder Replacement
  • Reverse Total Shoulder Replacement
  • Revision Shoulder Surgery
  • Revision Shoulder Replacement

Shoulder Replacement

The Shoulder Center specializes in total shoulder replacement surgery. A shoulder replacement is offered to patients who suffer from joint pain and dysfunction. Most shoulder replacements are the result of osteoarthritis. In some cases, severe trauma to the shoulder resulting in a fracture can require treatment with a shoulder replacement. For most patients with osteoarthritis, other forms of treatment are considered first, such as medications, injections and rehabilitation. If a patient doesn’t experience relief with these methods, a total shoulder replacement is often the next option to gain pain relief and increased mobility. Shoulder replacement surgery removes diseased or damaged bone in the shoulder and replaces it with an artificial joint. Reverse shoulder replacement is a unique type of shoulder replacement for combined arthritis and rotator cuff muscle tearing/deficiency.

Before a patient’s surgery they should be prepared and expect the following:

  1. You should stop eating or drinking hours before surgery.

  2. If you take a daily medication, ask if you should still take it the morning of surgery.

  3. At the hospital, your temperature, pulse, breathing, and blood pressure will be checked.

  4. An IV (intravenous) line may be started to provide fluids and medications needed during surgery.

When The Shoulder Center team is ready, you’ll be taken to the operating room. There you’ll be given anesthesia to help you sleep through surgery. Your surgeon may replace just the ball (partial replacement) or both the ball and the socket (total replacement). An incision about six inch es long is made from your collarbone to your arm. Once the new joint is in place, your surgeon closes the incision with surgical staples or sutures (stitches).

Source: Health Source Library: www.healthsource.baylorhealth.com

After surgery, patients will be scheduled for follow-up appointments and be given instructions for proper rehabilitation. Please seek medical attention if you or someone you know is experiencing shoulder pain.



Reverse Shoulder Replacement

The Shoulder Center performs reverse shoulder replacements. A reverse shoulder replacement is a procedure developed for patients who have severe shoulder arthritis with a coexisting rotator cuff tear. Patients who require this procedure have developed rotator cuff arthropathy, which is arthritis of the shoulder joint that develops because of a massive rotator cuff tear that is no longer repairable. In this situation typically at least two of the four rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis) are torn or dysfunctional for rotator cuff arthropathy to develop. Patients who suffer from rotator cuff arthropathy have significant loss of functionality in the affected shoulder. Most patients are unable to lift their arm to shoulder height.

A reverse shoulder replacement may be recommended to patients who are experiencing the following:

  1. A rotator cuff that is torn and can’t be repaired.

  2. A shoulder replacement that proved to be unsuccessful.

  3. Cuff tear arthropathy (arthritis of the shoulder with a torn rotator cuff).

  4. Injury or trauma to your shoulder.

  5. Trouble lifting your arm away from your body.

The reverse shoulder replacement allows patients to regain full functionality of the shoulder, increased mobility and pain relief. This procedure can help restore a patient’s ability to position their arm overhead. Most of the time, a reverse shoulder replacement is performed as an inpatient procedure. After surgery, a patient will be required to wear a sling to keep the shoulder immobilized. Physical therapy will be an important part of a patient’s road to recovery. If you are experiencing any of the symptoms described above, please seek medical attention.



Arthroscopic Rotator Cuff Repair

The Shoulder Center specializes in arthroscopic rotator cuff repairs. The rotator cuff is made up of the muscles and their associated tendon attachments to bone in your shoulder. These muscles and tendons connect your upper arm bone with your shoulder blade. They also help hold the ball of your upper arm bone firmly in your shoulder socket. The combination results in the greatest range of motion of any joint in your body. A rotator cuff injury includes any type of irritation or damage to your rotator cuff muscles or tendons. Causes of a rotator cuff injury may include falling, lifting and repetitive arm activities — especially those done overhead, such as baseball, tennis or swimming. About half of the time, a rotator cuff injury can heal with self-care measures or exercise therapy. Rotator cuff repairs are fairly common and result from damage or irritation to your rotator cuff muscles or tendons. This includes:

  1. General wear and tear as you get older or participate in repetitive movement activities.

  2. Tendinitis. Tendons in your rotator cuff can become inflamed due to overuse or overload, especially if you’re an athlete who performs a lot of overhead activities, such as in tennis or racquetball.

  3. Bursitis. The fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed.

  4. Strain or tear. Left untreated, tendinitis can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear. Stress from overuse also can cause a shoulder tendon or muscle to tear.

Source: Health Source Library: www.healthsource.baylorhealth.com

Dr. Sumant "Butch" Krishnan performs the all-arthroscopic rotator cuff repair using minimally invasive techniques. The vast majority of these surgeries are done on an outpatient basis, meaning you can go home the same day as your surgery. Similar techniques are utilized for labral tears and biceps injuries. If you or someone you know is experiencing pain in the rotator cuff area, please seek medical attention.



Arthroscopic Bicep Tendonitis

The Shoulder Center performs arthroscopic Bicep Tenodesis on patients who need to repair an injured or degenerated biceps tendon. The repair will be done with a combination of small incisions to look inside the shoulder and sometimes a small open incision to repair and reattach the healthy part of the tendon. This procedure helps reduce soft tissue trauma. Pathology of the biceps tendon is common and includes tendinopathy, tearing and instability. The two primary options for addressing biceps tendon pathology are tenotomy (ie. cut) and tenodesis (ie. cut and reattach to bone). Numerous methods for tenodesis of the biceps tendon have been published. Tenodesis is generally recommended for younger, active patients.

Bicep tenodesis can be performed using arthroscopic, minimally invasive methods. This procedure can be performed with either a suture anchor or screw that is placed into the patient’s bone through small incisions to secure the tendon for healing. After this procedure, patients are usually kept in a sling to protect the repair but begin immediate range of motion exercises to prevent stiffness and promote earlier return of function. The Shoulder Center staff will evaluate and determine which patients are candidates for an arthroscopic bicep tenodesis.



Arthroscopic Shoulder Instability Repair

Arthroscopic shoulder instability repair is a procedure performed when a patient experiences a dislocation or instability in their shoulder. A patient’s shoulder joint is held into place by the rotator cuff, the labrum and the glenoid. Problems with any of these can cause instability in the shoulder. Shoulder instability is most common among young people and athletes and typically results from sudden shoulder injury where the shoulder dislocates and comes out of socket. This can happen from a car crash, fall or a number of other things that cause the shoulder to be forcefully dislocated from the joint. This can require surgical repair in certain situations. This is most commonly done using minimally invasive technique with several small incisions around the shoulder.

After arthroscopic shoulder instability repair, the patient will need to wear a sling to ensure proper healing. After a certain amount of time in a sling, the patient will begin exercises and rehabilitation to gain strength in the injured shoulder. As always, please consult a medical professional before returning to normal activity after surgery.