TMH Living Well: Solutions to shoulder injury or arthritis
Total Joint Replacement Options
Dr. Kevin Borchard
Tuesday, Aug. 25
6 to 7 p.m.
TMH Conference Rooms
Refreshments will be served.
From a dislocation playing football, dull pain after painting the house or aching pain with weather changes, shoulder problems can affect people of different age groups and walks of life. Shoulders are unique in that there can be multiple causes for discomfort.
In the teen years and early 20s problems often stem from traumatic injuries that result in a dislocation or subluxation due to a labral tear, acromioclavicular (AC) separation, or superior labrum tear (also known as a SLAP tear).
“Shoulder injuries are common in sports, especially in contact sports such as football, wrestling, basketball and hockey,” said Dr. Kevin Borchard, orthopedic surgeon with The Memorial Hospital.
As athletes age into their 30s, 40s and 50s they can face rotator cuff and bicep tendinitis, rotator cuff tears and acromioclavicular (AC) osteoarthritis. Common causes for these injuries include overuse and traumatic injuries. For those over 50, osteoarthritis and rotator cuff tears are usually the culprits.
Physical therapy and anti-inflammatory medicines and injections are often the first response to shoulder pain. Sometimes it’s all that’s needed to keep the pain at bay.
“Many shoulder injuries can be successfully treated with physical therapy and non-operative management. When these fail, surgery may be indicated,” Borchard said.
A shoulder scope, or arthroscopic surgery, is a common procedure that helps surgeons pinpoint issues and perform repairs within the joint. Repairs are carried out using a small camera and specialized instruments through separate small incisions.
“Arthroscopic surgery involves making very small incisions to insert a camera inside the shoulder. Larger incisions and soft tissue disruption can be avoided while allowing the surgeon to look inside and even operate,” Borchard explained.
According to the American Academy of Orthopaedic Surgeons, common reasons for arthroscopic shoulder surgery include rotator cuff repair, bone spur removal, removal or repair of the labrum, repair of ligaments, removal of inflamed tissue or loose cartilage, and repair for recurrent shoulder dislocation.
With arthritis or a massive injury, sometimes the shoulder joint needs to be replaced making a total joint replacement surgery necessary. There are three types of joint replacements—hemiarthroplasty, which replaces only part of the shoulder, conventional total shoulder arthroplasty and reverse shoulder arthroplasty.
“During conventional arthroplasty we reconstruct the normal anatomy of the shoulder, replacing a ball with a ball and a socket with a socket. With reverse shoulder arthroplasty we replace the ball with a socket and a socket with a ball. The reverse procedure has improved significantly since it was first introduced in the US around 10 years ago. It’s ideal for people with massive rotator cuff tears who can’t move or elevate their injured arm,” Borchard added.
During his nine years in the Air Force, which included time caring for cadets and athletes at the U.S. Air Force Academy and Prep School, Borchard performed hundreds of shoulder arthroscopies. During his fellowship, he received training and performed all types of total joint shoulder surgeries. He’s one of a few doctors in the region who is skilled at reverse shoulder arthroplasty.
With shoulder surgery, patients can expect temporary use of a sling followed by range-of-motion and strengthening exercises. Often, the rehabilitation will be guided by a physical therapist. Arthroscopies are completed on an outpatient basis while total joints may require a one or two night stay in the hospital.
“Rehabilitation is very important in having a great outcome,” he concluded.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig — improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.
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