A group of four muscles in the shoulder make up the rotator cuff, which help us lift our arms up in the air and rotate our shoulders. Often mistakenly called the “rotor cup,” a problem involving the rotator cuff is the most common cause of shoulder pain in patients over 40. The rotator cuff tendons, which attach the rotator cuff muscles to the humerus (arm bone) can become detached by an acute injury or from chronic use. When the tendon is torn away from the humerus bone, either partly or completely, patients can experience pain when reaching overhead or moving the arm to the side. People also commonly complain of pain when sleeping on their shoulder at night. An MRI or ultrasound of the shoulder can identify a torn rotator cuff. When nonsurgical alternatives fail to relieve the pain, patients often elect to have the tear repaired surgically. Surgical treatment of rotator cuff tears is a minimally invasive procedure and is the most frequent surgery Dr. Goldberg performs. This procedure is done arthroscopically, meaning a small camera is inserted into the shoulder and the procedure is done with the surgeon viewing the operation on a video monitor. The operation takes about 60 to 90 minutes and patients go home the same day. Dr. Goldberg is one of the most experienced orthopaedic surgeons in Southwest Florida in this type of surgery.
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Also called bursitis or tendonitis, shoulder impingement refers to the pain in the shoulder caused by the rotator cuff tendons being pinched or squeezed between the humerus (arm bone) and the scapula (shoulder blade) as the arm is raised. This may be due to the natural shape of the your shoulder, or from a bone spur rubbing (impinging) on the tendons as they move. Experts consider this is the earliest stage of rotator cuff problems. Dr. Goldberg has successfully treated over 1000 patients in Southwest Florida with impingement. Most of these patients do not require surgery and can have their symptoms relieved with medication and a supervised therapy. In some cases patients continue to have discomfort and choose to undergo an arthroscopic, outpatient procedure to remove the bone spurs and relieve the pain of impingement.
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A Bankart lesion is a specific type of labral tear caused by a dislocated shoulder. This type of tear is most common in younger patients and involves a tear in the inferior glenohumeral ligament, causing aching, instability and a catching sensation within the shoulder.
Patients under the age of 30 who experience a Bankart tear are likely to sustain multiple shoulder dislocations and should seek treatment to correct the tear, which will allow them to partake in physical activities without worrying about an increased risk of dislocation. Surgery is usually performed after the second dislocation and involves reattaching the torn labrum to the socket of the shoulder. Most patients achieve successful results from this procedure.
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A distal clavicle excision is a surgical procedure performed to relieve pain in the acromioclavicular (AC) joint, which often develops as a result of a fall or other type of trauma. AC injuries may cause the two bones to move or separate, or the ligaments to stretch or tear. While conservative treatments are often used as initial treatment, surgery is needed in many cases to restore the position of the clavicle and allow the patient to resume normal functioning.
This procedure can be performed through traditional open techniques or using arthroscopy. During the procedure, a small part of the clavicle is removed to create a space between the two bones. Patients will need to undergo physical therapy after this procedure in order to restore movement and activity to the shoulder.
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A labrum is a protective cuff of cartilage found in ball and socket joints like the hip and shoulder. They provide more stability, cushioning and a full range of motion for these shallow joints. A tear in the labrum, known as a labral tear, is caused by injury or overuse and can lead to pain and "catching" of the joint while moving.
While many labral tears can be treated by managing pain symptoms and undergoing physical therapy, some cases require surgical treatment. Labral repair surgery aims to repair unstable shoulders with staples, anchors or sutures. The procedure is usually performed through arthroscopy, which allows Dr. Goldberg to view the tear through a small camera and perform the procedure through tiny incisions. Larger tears may require an open procedure.
Labral repair surgery is usually effective in treating labral tears and restoring full movement and strength. Recovery time depends on the type of procedure but usually takes several months.
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Shoulder resurfacing is used to effectively treat joint pain for patients with arthritis of the shoulder by restoring the damaged bone surface instead of replacing it as with joint replacement surgery. This treatment is modeled after hip resurfacing, which has been performed successfully for many years in patients who do not wish to or are not candidates for joint replacement.
During the resurfacing procedure, an implant is used restore the surface of the humerus bone, creating a smooth, capped surface without the need to remove the head of the bone. This procedure is less invasive and carries fewer risks than joint replacement. Patients can benefit from shorter recovery times as well.
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