Shoulder Injuries & Treatments

Not too long ago, the common approach to shoulder problems always began with taking pills to mask pain and strengthen remaining structures to take up the slack for damaged ligaments and tendons. This was usually supplemented with repetitive cortisone injections. The negative consequences of prolonged anti-inflammatory medicine use and cortisone injections have now been delineated. The Center for Advanced Sports Medicine Knee and Shoulder believes in minimally invasive mechanical solutions to mechanical problems, with medicines used to help the patient thru rehabilitation, not replace it.

Our shoulder practice cares for patients from adolescents to senior citizens, with particular emphasis on realistically maximizing outcomes. Treatment choices and consequences are thoroughly explained, so we can help optimize and individualize each patient’s care.

Reverse Total Shoulder Replacement

Shoulder joint replacement surgery (also called shoulder arthroplasty) is a great treatment for many people with shoulder pain from arthritis. But patients who don't have enough muscle function to stabilize the joint may not be able to benefit from the traditional implant design -- one that mimics the normal anatomic shoulder.

Instead, a different type of shoulder replacement, called reverse shoulder replacement has been developed. And it has worked so well, surgeons have expanded the number and types of patients who can qualify for this type. The reverse shoulder replacement does exactly as the name suggests: reverses the socket and the ball, placing the ball portion of the shoulder where the socket used to be and putting the socket where the ball or humeral head would normally be.

This new design gives a much more stable shoulder joint that can function without an intact rotator cuff. The artificial joint itself provides more stability by creating a deeper socket that prevents the ball from sliding up and down as the shoulder is raised. Shear forces are transformed into compressive forces. This simple change allows the large deltoid muscle that covers the shoulder to lift the arm. The result is a shoulder that functions better, is less painful, and can last for years without loosening.

Arthroscopic Nerve Releases in the Shoulder

The Suprascapular nerve supplies the power to the rotator cuff and its compression can cause pain and shoulder dysfunction often in normal MRI’s. Neuropathy can be caused by a variety of anatomic and pathologic entities as the nerve courses from the brachial plexus through the shoulder blade notches to innervate the rotator cuff muscles. Dr Levy has vast experience decompressing these nerves without open incisions. Often leading to marked improvements in pain and function in patients with pain and weakness that have been told there is nothing wrong with their shoulder.

The axillary nerve runs under the shoulder joint and can be pinched by arthritis spurs and tight tissue bands from the shoulder joint after trauma. Often on MRI’s there is specific atrophy of a small muscle called the Terres Minor. If this is noted on MRI reports or you are young and have shoulder arthritis arthroscopic axillary nerve decompression can be very helpful

Common Problems Treated

Shoulder Instability
Labral Tears
Impingement
Biceps Pain
Rotator Cuff Tears
Rotator Cuff Arthropathy
Arthritis
Cartilage Damage
Frozen Shoulders

Common Surgical Procedures

Arthroscopic Labral Repair (SLAP and Bankart)
Arthroscopic Acromioplasty (Subacromial Decompression)
Arthroscopic Rotator Cuff Repair
Arthroscopic and Open Cartilage Repair
Shoulder Replacement (Arthroplasty)
Reverse Total Shoulder Replacement
Tuberoplasty Partial Shoulder Replacement
Biceps Tenodesis
Revision Shoulder Surgery
Arthroscopic Shoulder Release of Adhesions

Cutting Edge Concepts

Tuberoplasty As An Alternative to Reverse Total Shoulder Replacement
Subchondroplasty For Early Arthritis
Scapulothoracic Arthroscopy
Arthroscopic Releases and Decompression of Axillary and Suprascapular Nerve
Superior Capsule Reconstruction