Finding the right orthopedic shoulder specialist in Kansas City is key to getting the best treatment to increase mobility and decrease pain. While many orthopedic surgeons do a little shoulder work in their practice, very few actually specialize in shoulder joint injuries and treatments.
APEX Orthopedics & Sports Medicine has one of those doctors. Dr. Van den Berghe spent an extra year of specific fellowship training in sports medicine with an emphasis on the shoulder. This allows him to understand the ins and outs of shoulder injuries to successfully treat patients.
The shoulder is one of the more complex joints in the body, so it is very important that the care you receive comes from an experienced provider. Read on to learn more on what you should know before you visit an orthopedic physician for your shoulder injuries.
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. 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 key elements:
- Glenoid labrum: Around the “rim” of the glenoid cavity is a ring-shaped ligament called the labrum. The labrum’s primary functions are:
- Sealing the humeral head or “ball” to keep fluids within the joint
- Helping stabilize the shoulder joint
- Protecting 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 tendons attach to the scapula (another attaches to the radius at the elbow joint).
What is an orthopedic shoulder specialist?
An orthopedic shoulder specialist can be either an orthopedic surgeon or a Physical Medicine & Rehabilitation (PM&R) physician who holds additional training on the shoulder. Specifically, a shoulder specialist provides diagnoses and management for conditions affecting the joints, muscles, ligaments, tendons, nerves, and other physical structures in the shoulder. These conditions include:
- Rotator cuff tears
- Labrum tears
- Joint instability
- Shoulder dislocation
- Sports-related injuries
- And more
Orthopedic shoulder physicians are well versed in comprehensive conservative non-operative management options. Surgeons are also experts in surgical management of musculoskeletal conditions. The main goal is to create outcomes that maximize patients’ functionality so they can return to their regular activities.
Since shoulder-focused physicians are specialized doctors, after completing medical school they must go through a four year residency in a related field. In the best cases, they will also have additional fellowship training in shoulder joint diagnosis and treatment.
When you visit an orthopedic physician, you can expect to go through a detailed evaluation of your complaint and corresponding physical examination. Sometimes other tests are needed to determine the correct diagnosis. This may include X-rays, ultrasound, MRI, or other diagnostic testing.
Our physicians at APEX are in a unique situation as private-practice doctors. This allows our shoulder specialist, Dr. Van den Berghe, to create the most value and the best patient experience. Since we are not a huge facility, you receive more dedicated, personalized care centered around your needs and condition. While we offer recommendations based on our medical experience, we want each patient to feel confident in their choices.
For you, that means you will be the ultimate decision maker at the end of the day. During your appointments, Dr. Van den Berghe will focus on giving you all the information and details you need to make a wise decision. We see our appointments more as conversations rather than “here’s what you should do” sessions.
Orthopedic Shoulder Specialists typically start conservatively
Shoulder specialists will usually try conservative, non-operative measures when approaching injuries and diagnoses. Surgical management options may be part of the end discussion, but for a majority of shoulder complaints, invasive procedures are not the first or best choice. A few examples of conservative shoulder injury treatments include:
- Physical therapy tailored to your diagnosis
- Modifications in your activities
- Braces and slings
- Pain medication
- Steroid injections
- Orthobiologic injections (such as platelet-rich plasma or bone marrow aspirate concentrate)
At the end of the day, physicians will align their management recommendations with your goals. Therefore, two people with the same diagnosis may undergo two different management plans. For example, someone who is a competitive athlete may need more intensive management to get them back to full play, whereas someone who wants to be more functional and face less pain with daily activities may have successful outcomes with less intensive management.
Shoulder arthroscopy is a common surgical procedure
When conservative measures fail or an injury is too severe, a shoulder arthroscopy may be a surgical alternative to an open surgery. Dr. Van den Berghe has intensive experience in shoulder arthroscopy, which allows him to gauge whether or not this option is best for a patient and to provide a high-quality procedure.
During your shoulder arthroscopy with Dr. Van den Berghe, you will remain under general anesthesia. After creating a small incision, he will insert 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 accessing 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 with stitches
- 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 difficult to estimate how many patients may undergo 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, this 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.
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 sore, achy, and painful. This is to be expected. Keep in mind, the shoulder 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.
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 orthopedic shoulder specialists in Kansas City 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.