Shoulder Arthroscopic Procedures

The shoulder is made up of four separate joints. The interrelated action of these four joints allows the complex and extremely wide range of movements of the shoulder.

The ball-and-socket joint or glenohumeral joint, is the main joint of the shoulder. This joint is reinforced and assisted in its movement by the rotator cuff, a combination of four tendons and associated muscles. The muscles arise on various parts of the shoulder blade, and their tendons attach to the upper arm bone. (Tendons are stringy tissues that attach muscles to bone). A"ball" at the top of the upper arm bone (the humerus) fits neatly into a "socket " called the glenoid, which is part of the shoulder blade (scapula ). But unlike the hip joint , where the ball sits in a deep well protected socket ; the shoulder socket is very shallow. The shallow socket of the shoulder is given some extra depth by a structure socket is very shallow. The shallow socket of the shoulder is given some extra depth by a structure called the lab rum . The labrum is actually a thickened firm tissue that is attached to and surrounds the main Glenohumeral joint. It provides stability to the shoulder joint when it is lifted up in a movement like throwing. The surrounding ligaments, muscles and tendons that move the shoulder joint, help to keep it stable . One of the tendons of the biceps muscle runs through the shoulder joint and further helps to stabilize the joint. Because of this anatomy, the shoulder is the most frequently dislocated major joint in the body.

Between the rotator cuff and the bony arch of the acromion lie two fluid-filled sacs called bursae. They protect the rotator cuff and allow smooth movement of the tendons over the bone. It is also prone to a variety of other injuries and chronic problems that can be painful, cause sleep disturbances and hinder a person's ability to perform ordinary tasks or sporting activities. Most problems in the shoulder involve the muscles , ligaments and tendons rather than the bones. Shoulder injuries can be caused by sports activities that involve excessive overhead motion (such as swimming , tennis and cricket). But they can also be the result of everyday activities like painting , hanging curtains and gardening. The arthroscope is the most accurate diagnostic tool for confirming shoulder problems.

Shoulder dislocations and instability

The shallow ball-and-socket joint of the shoulder is the most frequently dislocated major joint in the human body. Most often, the shoulder dislocates as the upper arm bone (humerus) comes forward out of the joint.

Treatment

Replacing the shoulder back into position and immobilizing it in a sling for a few weeks is the most common treatment. Occasionally, surgery may be needed to relocate the joint. Some times, a tendency to experience further dislocations may develop, following the first dislocation. This problem is known as unstable shoulder.

If non-operative treatment in the form of muscle strengthening exercise fails, arthroscopic surgery in early cases and open surgery in late cases is recommended to stabilize the shoulder. Open technique involves transferring of a bone fragment to the deficient glenoid rim-Lasarjet procedure.