Shoulder Surgery

The shoulder is complex and requires the attention of a specialist. At Glacial Ridge, you’ll receive care from Dr. Joshua Thomas, an orthopedic surgeon who completed a rigorous one-year shoulder fellowship at Johns Hopkins University. “Fellowship training gives you an extra scope of practice, and it makes you an expert in the field,” says Thomas, who has performed more than 400 shoulder surgeries. “If you’re going to get a shoulder replacement, you need a surgeon with advanced training.”

Weakness, stiffness, and pain in your shoulder joint are not normal. The symptoms only worsen over time, so if you’re battling a shoulder condition, make an appointment with Dr. Thomas.

Causes of Shoulder Damage

• Rotator cuff injuries. The muscles and tendons of the rotator cuff surround the shoulder joint and keep it in place. Damage to the rotator cuff is most often caused by repetitive motion over time. Rotator cuff tears can also happen from a forceful injury, such as during a fall or accident.
• Osteoarthritis is known as wear-and-tear arthritis that damages the cartilage, which prevents the joint from moving smoothly.
• Fractures near the top of the arm bone may require replacement.
• Rheumatoid arthritis and other inflammatory disorders can damage the cartilage and the underlying bone in the joint.
• Osteonecrosis occurs when the bone is deprived of blood and collapses.

Shoulder Replacement

Dr. Thomas performs three types of shoulder replacement surgery: anatomic, reverse, and partial. The full shoulder replacements aim to remove the damaged area of the bone and replace the shoulder’s ball and socket joint with implants constructed of metal and plastic.

In anatomic shoulder surgery, implants that resemble the original ball and socket joint are inserted to replace the shoulder joint.

Reverse shoulder surgery is preferred when the joint is severely damaged by arthritis. “That’s for someone who has a rotator cuff tear that’s irreparable through conventional means, ” says Thomas. In the procedure, the ball and socket implants are reversed in position. The ball is attached to the shoulder blade, and the socket is connected to the upper arm joint.

In a partial shoulder replacement, only the ball at the top of the upper arm bone is replaced while the shoulder’s natural socket remains. If needed, special tools are used to smooth or reshape the socket.

All three procedures provide almost immediate pain relief to 90% of patients post-surgical recovery. The anatomic may offer a slightly better range of movement than the reverse shoulder replacement.

Recovery Time from Shoulder Replacement Surgery

The recovery time from shoulder surgery varies on several factors, including the procedure performed, the severity of your case, and your age. Usually, it takes 2 to 3 weeks to return to light office work, 4 to 6 months for most normal activity, and 6 to 12 months for complete recovery. Be sure to consult your surgeon about the type of recovery you can expect. Each case is different.

Rotator Cuff Repair

Rotator cuff tears can range from partial tears to complete ruptures, each with its own level of severity. Surgery may be recommended depending on factors such as the size and location of the tear, as well as the patient’s symptoms and functional limitations. Typical reasons for rotator cuff repair include pain, weakness, restricted range of motion, and lack of progress with conservative treatments like physical therapy.

Rotator cuff repair can be performed using several approaches. The most common method, arthroscopic repair, involves small incisions and employs a miniature camera (arthroscope) so Dr. Thomas can visualize and repair the torn tendon. Open repair requires a larger incision, facilitating direct access to the affected tendon. Mini-open repair merges aspects of both arthroscopic and open techniques, combining the advantages of each.

Rehabilitation and Recovery Time From Rotator Cuff Surgery

Recovery from rotator cuff repair surgery hinges on effective rehabilitation. After the procedure, patients have a customized rehabilitation program designed to address their specific needs and objectives. Physical therapy focuses on rebuilding shoulder strength, enhancing flexibility, and restoring function, all while mitigating potential complications like stiffness and re-injury. A gradual advancement through targeted exercises and activities is fundamental to achieving the best possible outcomes.

Shoulder Instability

Shoulder instability occurs from damage to the labrum, the tissue that holds the end of the upper arm bone in place, or from shoulder dislocation. Moving it in specific ways makes it feel like the shoulder is coming out of the joint. There may or may not be pain, but you’ll know it when you feel it. In mild cases, the instability will repair itself through non-surgical means, like physical therapy or activity modification. If the shoulder remains unstable, surgery may be an option, followed by rehab therapy. Recovery time ranges from six months to a year, depending on the type of activity.

SLAP Labral Repair

A SLAP Labral tear is an injury at the top of the upper arm where the biceps tendon connects to the shoulder labrum (the tissue that holds the joint in place). It’s associated with dull pain and a weakened shoulder. Causes can include injuries, like falling on an outstretched hand, quickly lifting a heavy weight above your head, and some exercises, like pushups and bicep curls. And sometimes, it’s wear and tear and repetitive stress on the shoulder.

Less severe cases of SLAP will resolve themselves with 6 to 12 weeks of physical therapy and non-surgical treatments like rest, anti-inflammatory medication, and cortisone shots. Otherwise, minimally invasive surgery, conducted through a less than half-inch incision, may be the best option. This “keyhole” introduces an arthroscope (tiny camera) and surgical instruments to remove damaged tissue and restore the labrum to its natural place.

Full recovery from SLAP surgery can take 6 to 9 months. If you have a desk job, plan to take at least one week off.

Elbow Procedures

Tendonitis (Golfer and Tennis Elbow)

Tendonitis, also known as “tennis elbow” or “golfer’s elbow,” strikes people who use repetitive motions that use the thumbs and two forefingers to grasp objects, like golf clubs, tennis rackets, or hand tools.

The tendonitis pain you experience is due to the inflammation where the muscles are connected to the bumps inside (golf) and outside (tennis) of the elbow by strong, ropy tissues called tendons. Your pain may also radiate down to the forearm and wrist.

Before recommending surgery, Dr. Thomas considers a range of non-surgical options:

• Rest (taking time off your game)
• Steroid injections
• Icing
• Brace
• Physical therapy to stretch and strengthen the affected areas

The surgical procedure for correcting these tendonitis conditions is to partially trim the bumps on the inside or outside of the elbow. This relieves the pressure on the tendons that are causing your pain.

Recovery is 2 to 6 weeks to return to daily activities, 3 to 12 weeks to return to work, and 4 to 6 months to return to sports. Depending on your recovery, you may need a brace at work or on the gridiron or tennis court.

Cubital Tunnel Syndrome (Elbow)

Cubital tunnel syndrome is a condition that occurs when the ulnar nerve, which runs through the cubital tunnel (a narrow passageway on the inside of the elbow), becomes compressed or irritated. This can result in numbness, tingling, and weakness in the ring and little fingers. It’s often caused by prolonged or repeated bending of the elbow, pressure on the elbow, or anatomical factors that increase pressure on the nerve.

Treatment may involve resting the elbow, wearing a brace to keep the elbow straight at night, physical therapy, and medications to relieve pain and inflammation. In severe cases, surgery is needed to relieve pressure on the nerve. Early diagnosis and intervention are crucial to preventing long-term nerve damage and improving symptoms.