Rotator cuff tendinitis

If you are experiencing shoulder pain, weakness, or limited range of motion, you may have rotator cuff tendinitis. This condition occurs when the tendons in the rotator cuff become inflamed or irritated, usually as a result of overuse or injury.

To diagnose rotator cuff tendinitis, I will perform a physical exam and may also order imaging tests such as an MRI or ultrasound to determine the severity of the inflammation and any associated damage to the shoulder.

Treatment for rotator cuff tendinitis may include a combination of rest, ice, anti-inflammatory medication, and physical therapy. I may also recommend corticosteroid injections to reduce inflammation and pain.

In more severe cases, surgical intervention may be necessary. Arthroscopic surgery can be used to repair any tears or damage to the rotator cuff, and a complete recovery can take several months.

It is important to seek treatment for rotator cuff tendinitis as soon as possible to prevent further damage and promote healing. If you are experiencing symptoms, schedule an appointment with me to discuss your options for treatment and recovery.

Arthroscopic labral repair (Bankart repair) animation

An arthroscopic Bankart repair (labral repair) for shoulder dislocations is a very common surgery in my practice. I recently found a good animation from Arthrex on YouTube that can be helpful for patients considering undergoing the procedure.

As always, feel free to contact my office with any questions.

Andrew

Reverse shoulder arthroplasty for complex shoulder osteoarthritis

Reverse shoulder arthroplasty has been used more frequently in patients with complex shoulder arthritis. This procedure is designed for patients who have severe arthritis and rotator cuff damage that has led to significant pain, weakness, and limited range of motion in the shoulder joint.

In a healthy shoulder joint, the ball-shaped end of the upper arm bone (humerus) fits into a shallow socket in the shoulder blade (scapula). The rotator cuff muscles and tendons hold the joint together and allow for a wide range of motion. In a reverse shoulder arthroplasty, the traditional ball-and-socket joint is replaced with a prosthetic device that reverses the position of the ball and socket components.

This reversed configuration of the joint allows the deltoid muscle to take over the function of the damaged rotator cuff muscles and tendons. This can provide significant pain relief and improve the patient’s ability to perform daily activities.

The procedure is performed under general anesthesia, and the surgeon makes an incision over the shoulder joint. The damaged bone and tissue are removed, and the prosthetic components are placed in the shoulder joint. The procedure typically takes two to three hours, and patients will need to stay in the hospital for a few days to monitor their recovery.

After the procedure, patients will need to undergo physical therapy to regain strength and range of motion in the shoulder joint. The length of time for recovery varies depending on the severity of the condition and the extent of the surgery.

Reverse shoulder arthroplasty is a safe and effective option for patients with complex shoulder arthritis who have not responded to non-surgical treatments such as physical therapy, NSAIDs, and corticosteroid injections.

If you are experiencing severe pain, weakness, and limited range of motion in your shoulder joint due to complex shoulder arthritis, I encourage you to reach out to our office or click here to discuss nonsurgical and surgical options.

Andrew

Total shoulder vs reverse shoulder replacement

As reverse shoulder replacements become more and more common, patients routinely come in asking about the difference between it and a standard total shoulder replacement. Here goes my explanation:

Anatomic Total Shoulder Arthroplasty:

An anatomic total shoulder arthroplasty, also known as a traditional shoulder replacement, involves replacing the ball-and-socket joint of the shoulder with a metal ball and a plastic socket. This procedure is typically performed when the patient has arthritis of the shoulder joint and has intact rotator cuff muscles.

During the procedure, the surgeon removes the damaged parts of the shoulder joint and replaces them with the artificial joint. The new joint is designed to replicate the natural movement of the shoulder, allowing the patient to regain a significant amount of mobility and function.

Reverse Total Shoulder Arthroplasty:

A reverse total shoulder arthroplasty, on the other hand, is a more recent innovation that was designed for patients with a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis. In these patients, the rotator cuff muscles are not functioning properly and cannot support the joint.

During a reverse shoulder replacement, the surgeon reverses the position of the ball and socket joint. This means that the ball is placed on the socket side of the joint and the socket is placed on the ball side of the joint. This changes the mechanics of the joint and allows the deltoid muscle to take over as the main muscle that powers the shoulder.

The purpose of the reverse shoulder replacement is to restore the patient's ability to lift the arm and perform activities of daily living. However, the range of motion may not be as good as with a traditional shoulder replacement.

In summary, anatomic total shoulder arthroplasty is best for patients who have arthritis of the shoulder joint and have intact rotator cuff muscles. A reverse total shoulder arthroplasty is best for patients who have a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis or significant deformity. Both procedures can help improve the patient's quality of life and restore function to the shoulder joint, but it is important to consult with your surgeon to determine which procedure is right for you.

As always, please feel free to contact my office with any questions.

Andrew

COVID-19 Update

I want to give everyone an update of the situation involving COVID-19 in our clinic. We have canceled all non-emergent or non-urgent surgeries until June 1. We’ve also canceled all non-urgent or emergent orthopedic clinic visits at the Everett clinic. Our Edmonds and Smokey Point locations are temporarily closed. We will be seeing patients in our Everett location daily. We are also trying to implement possible virtual video visits. I will keep you updated with any new information. If you have questions or have an urgent or emergent orthopedic issue, please call our clinic at 425-412-1875.

How do I treat my rotator cuff tear? #Seattle #AAOS

This post is a continuation of our talk on rotator cuff tears. Today, we will be discussing the symptoms and diagnosis of rotator cuff tears. Previous posts included:

• What is a rotator cuff tear?

• What causes rotator cuff tears?

• How do I know if I have a rotator cuff tear?

Nonsurgical treatment is usually based on avoiding activities that cause shoulder pain, nonsteroidal antiinflammatory medications, and extensive shoulder stretching at home or with physical therapy.  Often times, the pain in your shoulder is secondary to shoulder stiffness.  Once the stiffness has been resolved, the shoulder pain improves significantly.  In the past, many physicians have recommended steroid injections into the shoulder.  Many shoulder specialists, like myself, do not recommend this course of treatment often due to its negative effect on the rotator cuff tendon.  Steroid injections can make the rotator cuff tendon weaker and more prone to more extensive tearing.

If you had a significant injury that resulted in a rotator cuff tear or you have not improved with extensive physical therapy and home exercises, minimally-invasive rotator cuff surgery may be an option for you.  To learn more about rotator cuff surgery, continue reading here.