Shoulder Surgery

The human shoulder is made of 2 parts: the spherical and rounded edge of the arm bone and the shoulder blade socket – the glenoid. This joint is one of the “busiest” of the body’s joints and therefore might get worn and damaged with time. If the injury is one that disrupts the arm’s proper function, shoulder surgery might sometimes be performed to improve the condition.

The shoulder joint is known as very complicated to treat, but the sophisticated shoulder surgeries performed today can guarantee a significant improved in its condition. The orthopedic experts available to you at the Herzliya Medical Center’s hospital will provide you with a dedicated and professional care in order to solve your problem once and for all. Here you could read more about the shoulder surgeries performed at the hospital and understand which treatment will be right for your problem.

Joint strengthening shoulder surgeries

One of the most common problems related to the shoulder joint, especially among young people, is the weakening of the joint and tendon, ligament and muscle system around it. This condition could occur due to a direct injury in the shoulder, dislocation, strong pull or breaking of the shoulder bones (collar bone, shoulder blades, arm bones or upper ribs). These surgeries are considered very common and are performed in quite a few young people suffering from chronic shoulder problems.
In cases of joint weakening, recurrent shoulder dislocations can occur, a condition where the spherical part of the joint dislocates from the socket in the shoulder blade bone. To prevent this, the patient will first be referred to designated  physiotherapy exercises  whose purpose is to strengthen the shoulder area and provide support for the joint. If this treatment doesn’t help, surgical intervention will be considered.

One of the common ways to do that is arthroscopic shoulder surgery – a shoulder surgery during which a tiny incision is made, usually in the width of only 1 cm, above the joint to allow access to all the muscle, tendon and ligament systems in the treated area. Using tiny surgical tools, the surgeon can inspect up close the injured area, repair damaged tissue (torn muscle, for example), strengthen loose ligaments, remove accumulation of infections and even ease the friction between the bones. This way, infections or tears in the rotator cuff can also be treated – among the most important parts for the shoulder joint’s proper action. These surgeries can be performed via the conventional method, with a perpendicular 15 cm incision in the anterior or posterior of the shoulder, as per the nature of the problem.

These surgeries are relatively very long, and could take over 2 hours. The surgery is performed with complete anesthesia and requires fasting for 6 hours before it starts. By the way, arthroscopy is also performed for the examination of the shoulder joint only, and in those cases, it can be done under partial anesthesia, as per the patient’s request and the doctor’s recommendations.

Shoulder replacement surgery

Sometimes there is complete wear of the joint, after many years of constant activity. Mainly in older ages, the joint might stop functioning right, and can cause pain that cannot be treated with medication alone. In such cases, shoulder replacement will be the course of action in some cases. The shoulder joint might get to that condition when the patient has suffered for years from recurrent dislocations, infections and so on, leading to a real tear of the cartilage and the bones of the joint.

The “standard” shoulder replacement surgery will include placing a hard plastic prosthetic to the glenoid bone and “dressing” a second prosthetic made of metals and hard plastic over the humerus. Sometimes, the prosthetics will be reinforced with a special ceramic protective coating. These materials are considered very strong and are expected to significantly improve the joint’s durability.

There are also partial replacement surgeries, where an artificial prosthetic is used to solve 2 other common problems: the first is the simpler, in which only the cartilage is worn. In this case, a special prosthetic in the shape of a dome will be placed on the humerus, where the glenoid bone will remain as is.

The second problem is more complex and relates to cases where the entire system of the tissue surrounding the joint is injured, leading to a severe limitation in movement. In this case, a reverse shoulder replacement will be done – a surgery where the prosthetic will act in complete opposite to the original joint.

During a reverse shoulder replacement surgery, a spherical prosthetic will be placed on the glenoid bone, and the humerus will remain with a straight end that will be attached to the rounded prosthetic. This way, the opposite takes place, the shoulder joint actually gets a new “grasping point” which causes the operation of a different system of muscles, tendons and ligaments – and the shoulder can in fact return to optimal function.

Shoulder replacement surgeries will also be performed with a large incision along the shoulder, and under complete anesthesia. This is a complex surgery that also lasts at least 2 hours. This surgery also allows treatment of a significant injury in one of the joint bones.

Recovery after shoulder surgeries

Like in any orthopedic surgery, shoulder surgery also requires a long recovery, which includes prolonged physiotherapy and great care in using the treated joint at first. On the day the patient recovers and could sit in a chair, he will already be required to begin joint strengthening exercises, when the hospitalization can take even a week.

In the first weeks after the surgery, the patient will wear a sling over his arm to support the joint and not burden it too much. After several weeks of daily use, the sling will only be worn at night, for about 6 weeks.

In parallel, after 6 weeks, the patient could resume light activities (like driving) and after 2 and a half months, he could perform office work. However, full recovery after shoulder surgeries usually takes about 6 months.

At Herzliya Medical Center, only expert orthopedic surgeons with great experience in the field operate. The surgeon is personally in charge of the treatment from the moment the decision of surgery is made, during the surgery and the hospitalization and throughout the entire follow-up afterwards. During the hospitalization, the surgeon personally makes all treatment decisions, 24 hours a day.