Shoulder Arthroscopy

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What is an arthroscopy?

When there is damage below the surface of the skin that isn’t visible with the naked eye, special tools or procedures may be used to identify, diagnose and treat problems. An arthroscopy is especially helpful when treating shoulder injuries, as the procedure is less invasive and can shorten recovery time.

During the shoulder arthroscopy procedure, a small camera is inserted into the shoulder joint to guide the surgeon using small instruments to repair injuries.

To better understand how an arthroscopy works, we must understand the construction of the shoulder. It is one of the most used joints in the body, and is also one of the most complex.

The shoulder is made up of three bones: the humerus (the upper arm bone), the shoulder blade, and the collarbone. Other parts comprising the shoulder include the ball, which is the humeral head of the upper arm bone. It fits into the rounded socket in the shoulder blade, called the glenoid. Both of these surfaces are covered by articular cartilage that helps the bones glide smoothly against each other instead of grinding. Another type of cartilage called the labrum surrounds the glenoid to add stability and cushion the joint.

The shoulder capsule is surrounded by ligaments and tendons that hold the shoulder together. This bundle is called the rotator cuff. It covers the ball of the shoulder and attaches it to the shoulder blade. The rotator cuff also helps to keep the humerus centered in the shoulder socket.

When should you have a shoulder arthroscopy?

There are a few steps that are usually taken before surgery is recommended. It’s important to explore all non-surgical options including rest, physical therapy, lifestyle modification and medications to reduce inflammation.

An arthroscopic surgery may aid in relieving pain associated with:

  • Rotator cuff injuries
  • Labrum tears
  • Arthritis of the shoulder
  • Bone spurs
  • Dislocation

What to expect before, during and after surgery

Before surgery, you should go over any existing medical conditions and medications you are taking with your physician. You may also need bloodwork or other procedures done to safely perform your surgery.

Many times, arthroscopy is performed as an outpatient procedure, so based on your individual case, you may be able to go home a few hours after your surgery.

Depending on your procedure, you many need physical therapy after your surgery. Your surgeon should be able to recommend exercises to help you regain strength and mobility, as well as refer you to the proper therapy team.

As with any surgery, it’s important to adhere to your doctor’s recommendations after your procedure to ensure the best healing and return to daily activities.

To learn more about our shoulder specialists or to schedule an appointment, please visit www.neorthohospital.com

Shoulder Arthroscopy

Rotator Cuff Repair

Shoulder

The rotator cuff consists of muscles and tendons that hold the shoulder in place. It is one of the most important parts of the shoulder.

As people age and their physical activity decreases, tendons begin to lose strength. This weakening can lead to a rotator cuff tear. Rotator cuff injuries occasionally occur in younger people, but most of them happen to middle-aged or older adults who already have shoulder problems. This area of the body has a poor supply of blood, making it more difficult for the tendons to repair and maintain themselves. As a person ages, these tendons degenerate. Using your arm overhead puts pressure on the rotator cuff tendons. Repetitive movement or stress to these tendons can lead to impingement, in which the tissue or bone in that area becomes misaligned and rubs or chafes.

The rotator cuff tendons can be injured or torn by trying to lift a very heavy object while the arm is extended, or by trying to catch a heavy falling object.

The following are the most common symptoms of a rotator cuff tear. However, each individual may experience symptoms differently. Symptoms may include:

  • Recurrent pain, especially with certain activities
  • Pain that prevents sleeping on the injured side
  • Grating or cracking sounds when moving the arm
  • Limited ability to move arm
  • Muscle weakness

The symptoms of a rotator cuff tear may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is a Rotator Cuff Injury Diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for a rotator cuff injury may include the following:

  • X-ray. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

A rotator cuff may tear partially or fully. Partial tears do not completely sever the tendon from the shoulder.

Treatment for a Rotator Cuff Injury

Specific treatment for a rotator cuff injury will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Treatment may include:

  • Rest
  • Nonsteroidal anti-inflammatory medications
  • Strengthening and stretching exercises
  • Ultrasound therapy
  • Corticosteroid injection
  • Surgery (for severe injuries)

Treatment depends on the severity of the injury. If the tear is not complete, your health care provider may recommend RICE (rest, ice, compression and elevation). Resting the shoulder is probably the most important part of treatment, although after the pain has eased, you should begin physical therapy to regain shoulder movement. Your doctor may prescribe a nonsteroidal anti-inflammatory drug (NSAID) for pain.

To learn more about rotator cuff injuries or to schedule an appointment with one of our orthopaedic specialists, please visit http://www.neorthohospital.com.

 

Rotator Cuff Repair

Shorten Your Emergency Room Visit with Tips from Nebraska Orthopaedic Hospital

In an emergency, time is of the essence. The winter season often brings more emergency visits, and no one wants to spend their holiday season waiting to see a doctor.

“Everyone is potentially one step from a medical emergency, so being aware of the closest facilities can lead to shorter wait times and a better overall experience,” says Dr. Susan MacQuiddy, medical director at Nebraska Orthopaedic Hospital’s Emergency Department. “Our emergency physicians are dedicated to providing the highest quality of care to all patients in a safe and timely manner.”

In May 2014, the Center for Disease Control and Prevention (CDC) reported an average wait time of 30 minutes, and an average total time from arrival to discharge of slightly more than 120 minutes. Couple these delays with increasing patient volumes, and it’s no wonder some emergency rooms are overwhelmed.

Dr. MacQuiddy recommends following these guidelines to help shorten waiting times:

  • Be ready to answer health questions. While this may seem obvious, “your physician will need to know your medical history in addition to the current situation to advise the proper treatment procedures.”
  • Know where the closest emergency room is located. “It makes no sense to drive across town when an emergency room may be right next door.”
  • Be patient. “We know waiting while you’re in pain is terribly inconvenient, but rest assured we are working as quickly as possible to treat you and others around you.”

At Nebraska Orthopaedic Hospital, emergency patients wait a median of 20 minutes to see a health care team member, and are usually discharged within 90 minutes, depending on the nature of the emergency. Staffed by UNMC physicians and supported by emergency-trained nurses, the Emergency Department is open 24/7 to evaluate and treat all emergencies. Located on the southeast corner of 144th and West Center Road, Nebraska Orthopaedic Hospital provides quick, convenient care for West Omaha residents.

To learn more about the Emergency Department at Nebraska Orthopaedic Hospital, please visit www.omahaemergency.com.

Shorten Your Emergency Room Visit with Tips from Nebraska Orthopaedic Hospital

What is Knee Arthroscopy?

An arthroscopy is a medical term for a procedure used by physicians to see inside a joint or other part of the body to identify and treat damage. Arthroscopies are commonly performed on hips, knees and shoulders to examine the joints for inflammation or injuries.

A small camera called an arthroscope is inserted in the knee joint during the procedure. The images from the arthroscope are sent to a monitor, allowing the surgeon and team to see the joint in great detail. Using this technology, the doctor can assess damage and begin treatment.

After arthroscopy procedures are complete, our orthopaedic surgeons will work with patients to develop a personalized rehabilitation plan. These plans usually include physical therapy, and exercises to restore strength and mobility to the knee. Recovery times also vary according to types and severity of knee damage.

Knee arthroscopy patients usually enjoy a faster return to everyday activities than a traditional open knee surgery patient, usually within six to eight weeks. However, some high impact activities may have to be modified to protect joints. The medical team should recommend necessary lifestyle changes during the course of treatment.

To learn more about knee arthroscopy procedures or schedule an appointment with one of our specialists, please visit www.neorthohospital.com.

What is Knee Arthroscopy?

Treating Bunions

What is a bunion?

A bunion occurs when the joint connecting the big toe to the foot becomes inflamed and starts to bow out from the foot. Bunions can be caused from wearing shoes that are too tight or too small. These painful deformities can happen to anyone; however, most bunion cases are seen in women who wear tight, narrow shoes like high heels.

Bunions can cause the big toe to angle in toward the foot, and sometimes deform the second and third toes as well. As the bunion progresses, bursitis and arthritis may develop, making walking and moving around painful. It’s important to prevent bunions, and treat them as soon as possible.

Treatment

Prevention is key for bunions. Shoes with wide insteps, broad toe boxes and soft insoles can prevent bunions from forming. Avoid tight or sharply pointed shoes, and excessively high heels. To relieve pain on an existing bunion, consider having shoes professionally stretched or investing in protective pads.

Surgery may be necessary to ease pain when walking if the bunion has progressed too far. The procedure realigns the bones, ligaments and other areas to correct the position of the big toe. Many of these surgeries are outpatient, but recovery times are often long. Patients may experience swelling and stiffness post-surgery.

If you think you might developing a bunion, schedule an appointment today at http://www.neorthohospital.com or call (402) 609-1600.

Treating Bunions