When is shoulder surgery necessary?

Shoulder surgery may be necessary in various situations when conservative treatment methods are not sufficiently effective. Some of the most common reasons for shoulder surgery are

1. Rotator cuff tear: When one or more tendons of the rotator cuff, which stabilizes the shoulder, are torn and lead to a functional disorder of the joint.Even small tears should be sutured, otherwise the tear will enlarge over the next 5-7 years.
   A tendon tear does not heal on its own.
2. Shoulder instability: If the shoulder joint repeatedly slips out of its normal position (shoulder dislocation or shoulder instability), surgery should be considered to restore joint stability and prevent further damage to the joint.
3. Shoulder osteoarthritis: In cases of advanced shoulder osteoarthritis, surgery such as shoulder replacement surgery (shoulder arthroplasty) may be considered to replace the damaged joint with a prosthesis to restore function and strength.
4. Labral lesions: Treatment of labral lesions depends on the type and severity of the injury.
   In some cases, conservative therapy may be sufficient, which includes rest, physical therapy, pain medication and anti-inflammatory medication.However, if the injury is more severe and conservative measures do not produce the desired results, surgery may be necessary. During arthroscopic surgery, the doctor can repair or reconstruct the damaged labrum to restore pain-free shoulder function.
5. Shoulder fractures: In the case of severe fractures in the shoulder area, such as a fracture of the collarbone, humeral head or glenoid cavity, surgery may be necessary to bring the bones back into the correct position, stabilize them and thus ensure bone healing. A major advantage of this treatment is the possibility of functional follow-up treatment immediately after the operation to ensure that the joint remains mobile.
6. Shoulder impingement: If there is tightness under the acromion, tendons and bursae can become trapped, leading to pain and inflammation. If conservative treatment methods such as physiotherapy, anti-inflammatory medication and injections do not work sufficiently, surgery may be considered to widen the constriction and reduce the pressure on the tendons.
7. Tendonitis of the biceps tendon: In the case of severe tendonitis or tendon damage, such as the biceps tendon, surgery may be required to repair and reconstruct the guidance of the damaged tendon.
8. Frozen shoulder (adhesive capsulitis): In this condition, the shoulder joint gradually stiffens, resulting in severe pain and limited mobility.Surgery is usually considered as a last resort if conservative measures do not bring the desired improvement.

It is important to note that shoulder surgery is not always the first treatment option. Conservative approaches such as physiotherapy, pain medication or anti-inflammatory therapies are often used first. Surgery is usually only considered if these do not produce the desired results or if there is a serious injury or condition that requires surgical intervention. Each case is unique, and the decision for shoulder surgery should always be made in consultation with an experienced orthopaedic surgeon and traumatologist who can assess the patient's individual situation.

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What is the procedure for shoulder surgery?

The exact procedure for shoulder surgery can vary depending on the type of injury or condition being treated. However, here is a general overview of the typical procedure for arthroscopic shoulder surgery:

1. Preparation: prior to surgery, the patient will be informed by the anesthesiologist about the type of anesthesia that will be used for the surgery. There are two main types of anesthesia: general anesthesia and regional anesthesia (local anesthesia). The surgeon will discuss the planned procedure with the patient and explain the possible risks and benefits.
2. Entering the operating room: The patient is brought into the operating room and positioned on the operating table. The necessary preparations for anesthesia are made and the monitoring equipment is connected.
3. Arthroscopic instruments: The so-called arthroscopic technique is used for most shoulder operations. This involves making several small incisions around the shoulder. Tiny instruments, including a camera (arthroscope), are inserted into the joint through these incisions.
4. Exploring the joint: The camera enables the surgeon to view the inside of the shoulder joint in detail on a monitor. This allows him to identify the exact cause of the injury or problem.
5. Performing the operation: Depending on the diagnosis and the planned procedure, various repairs can be performed, such as repairing a torn labrum or a damaged tendon. The surgeon may also smooth or repair bone structures, such as the humeral head, or even use screws if necessary.
6. Completion of the operation: Once the necessary repairs have been made, the instruments are removed from the joint and the small incisions are closed with sutures or tape.
7. Recovery phase: The anesthesia is completed at the operating table and the patient is taken to the recovery room, where they are monitored by medical staff until they can be transferred to the ward, pain-free and awake.
8. Aftercare: The post-operative phase is crucial to the success of the operation. The patient will usually receive physiotherapy to restore and improve shoulder mobility and strength.

It is important to note that depending on the type of surgery and the patient's individual circumstances, the procedure may vary. The surgeon will provide the patient with detailed information about the planned procedure and aftercare before the operation.

What complications can occur during and after shoulder surgery?

With shoulder surgery, as with any surgical procedure, certain complications can occur. It is important to know that not every patient will develop complications, and the likelihood of complications can depend on several factors, including your condition, the type of surgery, and post-operative care. It is important that you discuss any questions or concerns about the surgery with your doctor before you decide to have the procedure. Your doctor will inform you of possible complications and take steps to minimize the risk of complications. In most cases, shoulder surgery is successful and most patients recover well after shoulder surgery..

Some possible complications during and after shoulder surgery include:

1. Infection: Wound infection can occur if bacteria enters the surgical wound. This can lead to pain, swelling, redness or pus formation.
2. Bruising or hematoma: Bleeding can occur after the operation and lead to a bruise in the shoulder.
3. Stiffness and restriction of movement: After the operation, shoulder stiffness may occur, which can restrict freedom of movement. The timing, performance and duration of the operation are of crucial importance. The earlier, the more tissue-sparing and the quicker the operation is performed, the lower the risk.
4. Nerve damage: In rare cases, nerves near the operation site can be affected, which can lead to numbness, tingling or weakness in the arm.
5. Post-operative bleeding: In some cases, post-operative bleeding may occur, which can cause pain and swelling.
6. Thrombosis: Immobility after surgery can increase the risk of thrombosis (formation of a blood clot) in the leg veins.
7. Shoulder instability: Some shoulder operations, particularly repairs of labral lesions or shoulder dislocations, can lead to renewed shoulder instability.
8. Allergic reactions: In rare cases, patients may develop an allergic reaction to anesthesia, other medications or implants used during surgery.

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Is it particularly important to be treated by a shoulder specialist when considering shoulder surgery?

Yes, it is particularly important to be treated by a shoulder specialist when considering shoulder surgery. The shoulder is a complex joint with a large number of structures that are closely interconnected. A precise diagnosis and qualified treatment are crucial for the success of the operation and the patient's recovery. Experience and routine count when it comes to the procedure. The earlier the diagnosis is made and any necessary surgery is performed, the more tissue-friendly and the quicker the procedure itself is carried out, the lower the risk after shoulder surgery A shoulder specialist is an orthopaedic and trauma surgeon who specializes in the diagnosis and treatment of shoulder injuries and diseases. These doctors have additional training and experience in shoulder surgery and are familiar with the latest techniques and treatment methods.

Shoulder surgery can be challenging and requires a high level of expertise and skill to achieve optimal results. A shoulder specialist can determine exactly what type of surgery is best for your specific condition and perform the surgery with the utmost care and precision.

In addition, a shoulder specialist can provide comprehensive pre- and post-operative care, including the creation of an individualized therapy plan for rehabilitation after surgery. Proper post-operative care and physical therapy are critical to full recovery of shoulder function.

If you have a shoulder injury or condition and are considering surgery, it is advisable to be examined and treated by a shoulder specialist. This is the only way to provide you with the best possible medical care and ensure that the surgery and recovery is a successful one.