shoulder joint

Shoulder joint problems can occur for a variety of reasons. In the vast majority of cases, conservative therapy - e.g. with physiotherapy, manual therapy, shock wave treatment, acupuncture or local infiltrations or infiltrations aimed at the joint - is sufficient for long-term relief of symptoms.

In some cases, however, there are structural problems that should be corrected surgically. The aim should always be to correct the cause and the existing damage.

In modern shoulder surgery, this is usually done by means of joint arthroscopy, as this is a minimally invasive and therefore very gentle surgical method.

Cartilage damage can also be treated with this method. All modern cartilage therapy procedures are offered in our department.

In rare cases, open surgery is necessary for serious conditions (such as a large tendon tear).

Even though the underlying disease can often be identified after a physical examination, we generally recommend X-rays or magnetic resonance imaging (MRI) to confirm the diagnosis.

You will decide which therapy is most suitable for you individually after a detailed consultation with us.

Which shoulder joint diseases can be treated arthroscopically? Below is a selection of the most common diseases.

Subacromial impingement syndrome

Pain in the shoulder area is often caused by impingement syndrome of the shoulder. This refers to the fact that the space of a tendon running under the shoulder roof (supraspinatus tendon) is constricted. When the arm is moved, the tendon is crushed, which can lead to discomfort and, in the long term, to tendon damage or even a rupture of the tendon (supraspinatus tendon rupture).

A bone tightness can usually be corrected very well arthroscopically, since the tendon usually only needs a few millimeters more space.

labral tears

Tears in the labrum can be chronically degenerative or acutely caused by an accident. Common symptoms can be feelings of instability or pain. In these cases, the labrum can be reattached to the bone arthroscopically. Special, very small "anchors" are usually used for this purpose.

acromioclavicular joint arthrosis (AC joint arthrosis)

Osteoarthritis of the acromioclavicular joint (AC joint) can cause persistent stabbing pain. If conservative therapy does not provide satisfactory relief, arthroscopic removal of part of the arthritic bone may be useful.

tendon tear (tendon rupture)

Tendon tears in the shoulder are a common condition. They can occur acutely as a result of an accident or be chronic due to wear and tear. They are often the result of untreated impingement syndrome.

Depending on which tendon (supraspinatus tendon, infraspinatus tendon, biceps tendon) is torn, different surgical procedures are used. Usually, an attempt is made to anchor the tendon back in its original place on the bone. In principle, the tendon then needs time to grow back into the bone.

shoulder instability

Shoulder instability can occur for various reasons. The most common reasons are general laxity of the ligaments or a previous dislocation (luxation of the shoulder, shoulder luxation) of the shoulder with bony tearing of the front joint lip. The corresponding treatments are usually completely arthroscopic, in rarer cases open surgery is necessary. It is important to precisely analyze the cause of the instability beforehand.

Calcified shoulder (tendinitis calcarea)

In the case of calcium deposits in the tendon, symptoms can be severe in episodes. This condition usually heals spontaneously over a long period of time. If symptoms persist for a long time, the calcium deposit can be removed by surgery. It is important to identify the cause and treat it.

Surgical technique

In most cases, a 1 cm long skin incision is required on the front, side and back of the shoulder. A camera is inserted into the joint via the rear access, protecting the articular cartilage. The entire joint can be inspected using special, very fine instruments and existing problems can be treated directly via the other two accesses. The operation is performed under general anesthesia.

inpatient stay

The inpatient stay usually lasts 1 – 2 nights.

follow-up treatment

The operated arm should be given some rest after the operation. This is normally recommended for a period of 3 - 5 days after the operation in a special bandage prescribed by us. After this, everyday activities are usually increasingly possible again. Activities that place particular strain on the shoulder should be avoided for 4 - 6 weeks after the operation. In special cases, for example after tendon repairs, the arm should be given some rest for longer (up to 6 weeks).

Physiotherapeutic exercise is useful after all shoulder operations, but is particularly important after tendon sutures.