Shoulder and Elbow Surgery

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The doctor might advise shoulder and elbow surgery if a painful condition does not improve with non-surgical treatment. Rest, physical therapy, and drugs or injections that can reduce inflammation and promote the healing of wounded tissues are all examples of non-surgical treatment. One of the body's typical reactions to injury or illness is inflammation. Swelling, discomfort, and stiffness are all symptoms of inflammation in a shoulder joint that is infected or damaged. (1)

Elbow surgery is a minimally invasive surgery that can be used to diagnose a range of elbow conditions. Many conditions that harm the cartilage surfaces and other soft tissues surrounding the joint can be treated with elbow surgery to ease their unpleasant symptoms. Elbow surgery may also be advised to remove loose bone and cartilage fragments or to loosen adhesions that are restricting motion. In some complex surgeries, open and arthroscopic surgery procedures are performed simultaneously. (2)

Awake Shoulder and Elbow Surgery

Definition and Overview

In the specialist field of orthopedic surgery known as shoulder and elbow surgery, problems affecting the shoulder and elbow joints are identified and treated. It entails the treatment of different degenerative illnesses, deformities, and injuries that affect these joints. Individuals with shoulder and elbow issues benefit from surgery to regain function, ease discomfort, and enhance the quality of life. 

Specialized surgeons treat diseases such as rotator cuff tears, shoulder impingement, shoulder instability, arthritis, tennis elbow, and golfer's elbow using a variety of surgical procedures, including arthroscopy, joint replacement, ligament repair, and fracture fixation. 

In order to help patients restore mobility, relieve discomfort, and enhance overall musculoskeletal health, shoulder, and elbow surgery combines surgical proficiency, rehabilitation, and patient-centered care.

Procedures

There are many kinds of shoulder and elbow surgery procedures. The procedure depends on the patient's specific needs and health conditions. The most common surgical procedures for shoulder and elbow include 

  • Shoulder Arthroscopy

During shoulder arthroscopy, a tiny camera called an arthroscope is inserted into the shoulder joint by the surgeon. The images from the camera are shown on a television monitor, and the surgeon utilizes them to direct tiny surgical instruments.

The physician may choose to make very small incisions rather than the larger ones necessary for traditional, open surgery because the arthroscope and surgical equipment are thin. Patients experience less discomfort as a result, and their recovery time is shortened.

  • Elbow Arthroscopy

In elbow arthroscopy, a tiny camera called an arthroscope is inserted into the elbow joint, and the surgeon utilizes the images to guide tiny surgical instruments. The images are displayed on a television screen by the surgeon.

The surgeon may utilize relatively small incisions rather than the bigger incision required for open surgery because the arthroscope and surgical equipment are thin. This results in less pain, and less joint stiffness for patients.

  • Shoulder Replacement

Although complicated fractures and other issues that cannot be fixed with conventional methods can also be treated with shoulder replacement surgery. This procedure is normally reserved for patients with advanced shoulder arthritis. In a normal shoulder replacement, a metal prosthetic ball and a plastic seat will replace the ball and socket joint.

  • Biceps Tendon Surgery

A muscle on the front of the arm is called the biceps. A tendon known as the long head of the biceps is located at the top. This tendon runs down the rotator cuff and connects to the labrum to join the muscle to the shoulder. Patients can have biceps tendon surgery on its own or in conjunction with rotator cuff repair. Surgery can aid in regaining the muscle's look, strength, and range of motion.

  • Open reduction and internal fixation (ORIF) for elbow

A damaged bone can be stabilized and healed using a procedure called open reduction and internal fixation (ORIF). This procedure may be required by the patient to treat their broken elbow. (3,4,5,6)

Candidates

Signs that a patient needs elbow surgery include;

  • joint pain
  • swelling and stiffness
  • locking joints and changing position,
  • constant and severe pain in the joint,
  • pain that worsens with use, 
  • stiffness after rest or activity, 
  • limited range of motion. (7)

Risks and Side Effects

Patients can experience some risks and side effects which can vary from person to person and procedure to procedure. These may include 

  • high temperature,
  • severe or increasing joint pain,
  • odorous white, yellow, or brown liquid oozing from the cut,
  • severe swelling or redness in or around the joint that may get worse,
  • tingling or numbness in the joint. (8)

Post-Procedure and Follow-up

After the procedure, the patient spends a minimum of one to two hours in the recovery area before being sent home. Patients may spend the night in the hospital for some complicated procedures. Nurses keep an eye on responsiveness and, if necessary, administer painkillers. 

Medications, the need for an elevation of ice, and proper dressing maintenance are all covered in the discharge instructions given to the patient. The patient might require a ride home and someone to stay with him for at least the first night. No matter what procedure the patient has, the doctor will schedule regular follow-up appointments. These patient appointments are highly helpful for a quick recovery. 

Recovery

The whole recovery duration varies for each patient due to the wide range of shoulder and elbow situations. 

In the case of a small repair, the patient might not require a splint and, following a brief period of rehabilitation, the range of motion and function might recover. A few days after the treatment, patients can go back to work or school.

Results

Recovery times are longer after more complex surgeries. It may last several months to fully heal. Although it can be a slow process, it is vital to follow the surgeon's instructions and rehabilitation plan to restore normal function of the shoulder and elbow.

  • 1,5- OrthoInfo by the American Academy of Orthopaedic Surgeons. Shoulder Arthroscopy. (https://orthoinfo.aaos.org/en/treatment/shoulder-arthroscopy/)

    2,6- OrthoInfo by the American Academy of Orthopaedic Surgeons. Elbow Arthroscopy. (https://orthoinfo.aaos.org/en/treatment/elbow-arthroscopy/

    3- Very Well Health. (https://www.verywellhealth.com/types-of-shoulder-surgery-4134622)

    4- Johns Hopkins Medicine.Elbow Fracture Open Reduction and Internal Fixation. (https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/elbow-fracture-open-reduction-and-internal-fixation)

    7,8- NHS. Why it’s done-Arthroscopy. (https://www.nhs.uk/conditions/arthroscopy/why-its-done/)

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