
Shoulder Surgery
Shoulder injuries happen frequently during sporting events and other forms of vigorous physical activity. Encompassing a broad range of disorders, the term shoulder instability (or a condition in which the shoulder slips in and out of the joint) basically indicates any condition in which this vital part is pulled out of joint, dislocated, or rendered loose or lax.
The types of shoulder surgery that Dr. Tallman performs are the following:
Arthroscopic SLAP Repair: A SLAP (Superior Labral Anterior Posterior) tear is an injury to the rim of cartilage that encircles the shoulder socket (known as the labrum). Arthroscopic repair of detached tissue can be performed on young athletes and other types of tears can be removed so they no longer cause pain symptoms.
Arthroscopy for Shoulder Dislocation: A shoulder dislocation injury occurs when the ball of the shoulder joint comes out of the socket. In young athletes, the damage most commonly occurs at the labrum. To stabilize the shoulder after dislocation, a type of surgery known as a Bankart repair can reattach the labrum to the shoulder socket, and repair the joint capsule to hold the ball in place.
Rotator Cuff Repairs: One of the most common surgical procedures for the shoulder is a rotator cuff repair. In most cases, this surgery can be performed arthroscopically. The goal of the surgery is to identify the damaged part of the rotator cuff and to clean and reattach any torn or damaged tendons. Once the healthy tissue is found, the surgeon will use different techniques to restore the tendon without excessively stretching the remaining tissues.
Acromioclavicular (AC) Joint Repairs: The acromioclavicular joint, commonly known as the AC joint, is the junction of the end of the clavicle (collarbone) and acromion. There are several problems that can occur at the AC joint. The first is that it can wear out. This can occur as a result of arthritis, usually at the site of previous trauma. It can also deteriorate due to a repetitive use injury, such as weightlifting (a condition referred to as distal clavicle osteolysis). If either of these conditions occurs, open surgery may be performed to remove the end of the collarbone and widen the AC joint space. Another type of AC joint repair can be performed when the joint is separated due to an injury and the collar displaces upward.
Biceps Tendon Surgery: The bicep is a muscle on the front of your arm. At the top end is a tendon, called the long head of the bicep, that attaches the muscle to the shoulder by traveling through the rotator cuff and affixing itself to the labrum. This complex relationship makes the long head of the biceps a common target for shoulder problems. Biceps tendon surgery can be performed in isolation or as part of a rotator cuff repair. There are generally two approaches used. One is to sever or release the tendon connection inside the shoulder joints. The other is to release the tendon and then reattach it outside of the shoulder joint, and this can be done through arthroscopic and open techniques.
Shoulder Replacement: Shoulder replacement surgery is typically reserved for advanced arthritis of the shoulder joint but can also be used for complex fractures and other problems that cannot be repaired with other techniques. A typical shoulder replacement will replace the ball and socket joint with an artificial ball made of metal and a socket made of plastic.
Arthroscopy for Impingement Syndrome: Impingement syndrome can also be described as rotator cuff tendonitis and bursitis. The arthroscopic procedure used to correct impingement is known as subacromial decompression. The aim of the surgery is to increase the space between the rotator cuff and the top of the shoulder (known as the acromion). The surgeon removes bone spurs and can “clean up” the frayed or worn tendons and remove inflamed bursal tissue.
In severe cases in which surgery is needed, both open surgery or arthroscopy (a minimally invasive procedure in which an illuminated arthroscope is inserted through a small incision to inspect and repair damage in the shoulder) might be considered, with the goal always being to repair and strengthen the impaired shoulder ligaments and tendons.