Written by Anastasios Deligeorgis, Orthopedic Deputy Director of the 3rd Orthopedic Clinic HYGEIA
Our shoulders are prone to injury as they are involved in almost every activity we do. This explains why shoulder pain is a common problem that afflicts millions of people around the world. The pain can make the entire hand dysfunctional, so that even simple daily activities, such as combing or dressing, become difficult.
Immediate treatment and treatment is necessary, because otherwise the pain and difficulty in moving the shoulder may worsen over time. When they are not treated conservatively, surgical treatment is recommended. Minimally invasive techniques with small holes, digital technology, the latest materials and fast track protocols make the operations personalized, adapted to the different needs of each patient and can cure shoulder pain more quickly and permanently. In this way, long and long surgeries with large incisions, long-day hospitalization and difficult rehabilitation are avoided.
Causes and Diagnosis
The pain is due to diseases and injuries of the shoulder joint (bones, cartilages, tendons, muscles, nerves). More rarely, it may be due to a condition in another part of the body (eg the neck) that reflects on the shoulder.
The diagnosis is made from the patient’s history and clinical examination, while it may be necessary to perform some imaging tests, such as x-rays, magnetic resonance imaging or computed tomography.
At first symptoms can be treated conservatively with:
• rest, in some cases with a guardian, for the partial immobilization of the shoulder.
• use of cold patches (ice therapy) and less often, hot ones.
• administration of painkillers and anti-inflammatory drugs.
• intra-articular or peri-articular injections with hyaluronic acid or cortisone.
• in specific conditions, biological treatments from the patient’s own cells, such as PRP (platelet-rich plasma) or stem cells).
• physical therapy and muscle strengthening.
In cases where conservative treatment fails, arthroscopy has its place, a minimally invasive method, which allows us to diagnose and treat shoulder problems, without hospitalizing the patient. The orthopedic surgeon, by inserting the arthroscope, which carries a tiny high-resolution camera, into the shoulder through small holes (3-5 mm), can:
• to carefully examine the inside of the joint and to locate with great precision any damages, even very small ones, and in the most inaccessible places.
• to immediately repair the damage with the help of very fine tools.
In most cases, the arthroscopy takes about an hour, the patient is mobilized immediately after the surgery and returns home the same day.
Minimally Invasive Arthroplasty (MIS)
Especially for arthritis, when conservative treatment is no longer effective, minimally invasive arthroplasty provides the solution.
It is an operation to replace the damaged surfaces of the shoulder joint with implants, very durable and compatible with the body. The main types of shoulder arthroplasty are: total arthroplasty (replacement of the joint with an artificial one), partial arthroplasty (replacement of part of the joint) and reverse total arthroplasty (replacement of the entire joint with a special prosthesis by reversing the normal anatomy of the shoulder).
Newer minimally invasive techniques with smaller incisions, the use of digital technology and navigators to plan the surgical steps based on the anatomy of each shoulder and to perform them with millimeter precision, offer a better and faster result than traditional arthroplasty.
The patient can get up immediately after the surgery, as soon as the anesthesia wears off, with immediate hand mobilization and return home after a few hours or 1 day, always depending on his clinical condition and health history.
Either conservative or invasive treatment is almost always complemented by a rehabilitation program aimed at regaining the range of motion of the shoulder joint and strengthening the muscles.
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