Whether you face a labrum tear, rotator cuff injury, or another musculoskeletal shoulder issue, shoulder arthroscopy in Kansas City is a safe and effective way to treat those conditions without the need for an open procedure.
In the past, many physicians limited arthroscopy procedures to the knee, but with modern technology and updated techniques, orthopedic surgeons can now successfully perform shoulder arthroscopy.
While many physicians do not solely specialize on the shoulder joint and its procedures, Dr. Van den Berghe at APEX Orthopedics & Sports Medicine is one of the few surgeons whose practice centers around shoulder injuries. Since finishing his training in 2004, he has evolved into one of the leading physicians in conservative and surgical shoulder treatments for patients from their teens all the way to their nineties.
Those interested in learning more about shoulder arthroscopy, continue for our in-depth look into the treatment.
The anatomy of the shoulder joint
Before we can discuss how a shoulder arthroscopy works, there are some basic things you should know about the shoulder joint (glenohumeral joint) in general.
There are different types of joints in the body; the shoulder is a “ball-in-socket” joint. Just as the name suggests, a ball-in-socket joint comprises a ball-like structure that moves inside a depression in the bone to allow for rotational movements. The shoulder joint is created by the ball-shaped head of your humerus (upper arm bone) that fits into the glenoid cavity in the scapula (triangular-shaped bone on your posterior side).
Shoulder stability, which is crucial to prevent injuries, comes from four fundamental elements:
- Glenoid labrum: Around the “rim” of the glenoid cavity is a ring-shaped ligament called the labrum. The labrum’s primary functions are:
- Seals the humeral head or “ball” to keep fluids in the joint
- Helps stabilize the shoulder joint
- Protects the surrounding the cartilage
- Rotator cuff muscles: Rotator cuff muscles are a group of four muscles (and their tendons) designed to provide strength and durability during various shoulder movements. They help keep the joint stable so large muscles such as your deltoid, pectoralis, and latissimus can create the power you need for lifting, throwing, or carrying items.
- Ligaments: Ligaments are durable, dense connective tissue to help keep the shoulder in place and prevent dislocations.
- Biceps tendon: Muscles require tendons to connect to the bone. Two biceps tendon attach to the scapula (another attaches to the radius at the elbow joint).
Conservative measures for shoulder injuries
When each element of the shoulder joint works in perfect alignment and harmony, you are able to move with your full range of motion. However, injuries may occur that lead to pain and movement restrictions. In some cases, your orthopedic physician may recommend a shoulder arthroscopy to repair the injury.
Keep in mind, surgery isn’t often the first choice. In fact, Dr. Van den Berghe typically leans toward more conservative measures before deciding an arthroscopy is the best solution.
Many people believe that the best thing to do for the joints is to rest. Whenever pain flares, rest can be helpful; however, joints love to move. They depend on natural lubrication from synovial fluid; similar to how oil lubricates gears, synovial fluid helps your joints move.
First, movement increases the amount of synovial fluid, which can help reduce pain. Second, motion increases circulation through the entire body. That circulation helps supply the necessary nutrients and oxygen needed to promote joint health.
This is incredibly beneficial since a lot of people live a relatively sedentary lifestyle. Many sit at a desk in front of a computer screen for hours on end without movement. As a result, the body, including your shoulders and hands, remain in an awkward position and posture isn’t the best.
A physical therapist may work with you 2 or 3 times a week, focusing on the biomechanics of the body, shoulder, and scapula to promote better positions.
At times, the pain becomes too much and hinders movement. In those instances, your doctor may recommend over-the-counter NSAIDs (anti-inflammatory medication such as Advil) or prescription medications. Especially with NSAIDs, you should always talk to your doctor to ensure they are the right treatment for you. Side effects can include stomach irritation, ulcers, or even kidney damage. Reasonable dosing and monitoring can help alleviate those side effects.
Another pain management option for shoulder injuries is injections. Cortisone injections, for example, can help reduce inflammation, and the effects tend to last for 3 to 6 months before you might need another one. Many people manage their pain with injections and physical therapy.
Regenerative medicine options, such as stem cell injections or platelet-rich plasma, can help nourish worn or damaged tissue. This option works best if you have mild-to-moderate shoulder pain.
What happens during a shoulder arthroscopy at APEX Orthopedics & Sports Medicine?
The shoulder is considered a more unstable joint because of the way the bones articulate with each other; you can think of it like a golf ball on a tee. And since it has more planes of motion than joints like the knee, shoulder arthroscopy requires different techniques.
During your shoulder arthroscopy with Dr. Van den Berghe, you will remain under general anesthesia. After creating a small incision, he inserts a tiny camera (arthroscope) into the shoulder joint, giving him a clear guide for the surgical instruments. Saline-based fluid flows through the arthroscope to keep the image clear and bleeding minimal. This is quite different from an open surgery, which requires a much larger incision and longer recovery times.
After assessing the shoulder injury and the condition of the labrum, Dr. Van den Berghe will begin the repair. Depending on your shoulder, this could include:
- Repairing the rotator cuff
- Repairing the labrum
- Smoothing out the surrounding cartilage
- Removing inflamed tissue
- Reshaping joint to prevent recurring dislocations
Once the procedure is complete, Dr. Van den Berghe will close your incisions and apply an absorbent dressing.
How many patients typically need a shoulder arthroscopy?
It is sometimes difficult to estimate how many patients require a shoulder arthroscopy. Dr. Van den Berghe strives to be as conservative as possible, meaning he does not want to offer surgery unless a patient truly needs it. For you, that means you don’t have to worry about him (or any APEX physician) pushing a surgical procedure, especially when other treatment options could help. That is part of our dedication to bringing value to our patients as a private-practice model.
Fortunately, Dr. Van den Berghe can manage shoulder, and even knee injuries non-operatively with physical therapy. However, in some cases where patients have failed conservative treatments or have more extensive injuries, surgery may be the best and only option. Before taking action, Dr. Van den Berghe always has an in-depth conversation, enabling patients to make the decisions for themselves.
What to expect from the shoulder arthroscopy recovery process
The shoulder tends to be a more painful joint to operate on because of its proximity to the head and neck and the concentration of nerve endings. Therefore, after surgery, the shoulder is typically more sore, achy, and painful compared to other joints. This is expected. Keep in mind, this joint is more complicated than the knee, which is why recovery usually takes longer. Most people are in a sling for at least a month, but for more severe cases, it may be extended to two months.
As time passes, you will gradually notice an improvement for up to a year.
How to be proactive and prevent shoulder injuries
Since most people generally lead a more sedentary lifestyle, it is important to put effort into maintaining good posture (ensuring the shoulder is in good position of the scapula), focusing on core strength, and promoting healthy mobility of the thoracic spine.
To do this, get up and move around throughout the day. While working, it’s best to pay attention to ergonomics. Some people use sit-to-stand desks, which support proper posture and alignment. Remember, sitting down too much can take a toll on your body in the long run, so the more you can stay active with light activity each day, the better.
Some athletes, such as baseball pitchers, can form a condition called a glenohumeral internal rotation deficit (GIRD), even at a very young age. To avoid tightening in the shoulder, be mindful and perform simple stretches to keep the area loose. Pitchers should monitor pitch counts and how much they are throwing.
Oftentimes, when Dr. Van den Berghe sees athletes at an earlier age, he can help establish better patterns so they can avoid labral and/or rotator cuff injuries.
Get to Know Dr. Van den Berghe at APEX Orthopedics & Sports Medicine
Dr. Van den Berghe is one of the few fellowship-trained orthopedic surgeons who specializes in shoulder injuries and surgical treatments. In his practice, he treats just about everything to do with the shoulder—fractures, arthritis, people who need a total shoulder replacement, reverse shoulder replacements, etc. He will also examine and treat knee injuries such as meniscus or ACL tears.
With his passion for the complexity of the shoulder and offering the best treatments for his patients, Dr. Van den Berghe builds a unique rapport and relationship with every person he works with. He doesn’t believe he should be the sole decision maker in treatment; rather, he allows the patient to decide what they believe is best based on his expert recommendations.
Learn more about shoulder arthroscopy at APEX Orthopedics
By utilizing the benefits of APEX’s private-practice model, Dr. Van den Berghe ensures each patient receives the most value possible during their visit.
The core of his success lies in proper diagnosis. An appointment with Dr. Van den Berghe includes the highest quality technology to pinpoint a patient’s underlying musculoskeletal conditions. From there, he can better understand which sports medicine treatment will work best for you.
For a thorough evaluation of your shoulder pain or other orthopedic concerns with Dr. Van den Berghe, call us at 913-642-0200 or schedule an appointment today.