Shoulder and Elbow Treatments at Fitzwilliam Hospital
Your shoulder and elbow joints are composed of bones that are covered with articular cartilage to protect the bones and enable them to move easily. A thin, smooth tissue called synovial membrane covers all remaining surfaces inside the joint and lubricates the cartilage. Muscles and tendons hold the joint together providing stability and support. Your shoulder is a ball and socket joint and your elbow is a hinge joint.
Fractures, osteoarthritis, rheumatoid arthritis, cartilage damage, tendon tears and instability are responsible for most shoulder and elbow problems. Shoulder and elbow surgery aims to restore the full use of your shoulder or elbow without pain.
Here at Fitzwilliam Hospital we offer rapid access to diagnosis and treatment of shoulder and elbow conditions. Our experienced shoulder and elbow surgeons provide a full range of the latest surgical procedures for shoulder and elbow problems, performed in a fully equipped ultra clean air theatre suite. They work alongside consultant radiologists and chartered physiotherapists to ensure you receive the best treatment throughout your journey.
Shoulder and elbow arthroscopy
Shoulder or elbow arthroscopy is minimally invasive surgery used to diagnose and often treat a shoulder or elbow problem.
Arthroscopy is performed under general anaesthetic and your orthopaedic surgeon will insert a thin metal tube with a camera and light, called an arthroscope, into your shoulder or elbow joint through small incisions.
Shoulder and elbow arthroscopy is often used to remove loose pieces of bone and cartilage.
Shoulder arthroscopy can be used to:
- Repair rotator cuff
- Remove bone spurs or inflamed tissue
- Remove or repair the labrum
- Repair ligaments
- Repair recurrent shoulder dislocation
Elbow arthroscopy can be used to treat:
- Tennis elbow
- Osteoarthritis (wear and tear arthritis)
- Rheumatoid arthritis (inflammatory arthritis)
- Osteochondritis dissecans
- Scar tissue to offer a greater range of motion
Rotator cuff repair
Your rotator cuff is made up of a group of four muscles and tendons that connect your upper arm bone (humerus) to your shoulder blades and it holds your humerus in place in your shoulder socket.
Injury may cause a partial or complete tear. A partial rotator cuff tear may be treated by trimming or smoothing, known as debridement. A complete tear is repaired by stitching the torn tendon back onto the head of your humerus.
Rotator cuff repair surgery can be performed using arthroscopy or open surgery. Your shoulder surgeon will discuss the most appropriate surgery procedure with you.
Dislocated shoulder surgery
Your shoulder becomes dislocated when your upper arm pops out of your shoulder socket. This is one of the easiest joints to dislocate as the shoulder socket is shallow.
If you have repeated dislocations, known as shoulder instability, or tissue or nerve damage due to a dislocation, then surgery will usually be recommended. Surgery will repair your damaged tissues and this may also reduce your risk of dislocating the same shoulder. It is performed under general anaesthetic, often using arthroscopic keyhole surgery. If your surgeon needs to move your shoulder bones to prevent further dislocations, then they would recommend open surgery.
Shoulder replacement surgery
Shoulder replacement surgery is an effective procedure to relieve shoulder pain and help you to resume your everyday activities. Your shoulder surgeon may recommend it if your pain is due to osteoarthritis, rheumatoid arthritis, arthritis following an injury, a cuff tear developing arthropathy (arthritis and cartilage destruction), avascular necrosis (disrupted blood supply to your bones) or a severe fracture.
There are different types of shoulder replacement surgery but all involve removing and replacing damaged parts of the shoulder:
- Partial shoulder replacement surgery – also known as hemiarthroplasty, involves replacing part of your shoulder joint, often the ball section.
- Total shoulder replacement surgery – also known as shoulder arthroplasty, involves attaching an artificial ball and socket.
- Reverse shoulder replacement – involves attaching a ball and socket but switching their places with each other.
Elbow replacement surgery
Total elbow replacement surgery involves replacing your elbow joint with a new artificial one made up of a metal and plastic hinge and two metal stems. A total elbow replacement may be recommended to relieve elbow pain and disability caused by rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, fractures and instability.
Sometimes a partial elbow replacement will be recommended. Your elbow surgeon will discuss the best treatment and components for your individual needs.
Tennis elbow (lateral epicondylitis)
Tennis elbow, also known as lateral epicondylitis, is the inflammation of a muscle tendon on the outside of your elbow caused by repeated strain of your extensor carpi radialis brevis (ECRB) muscle and results in pain on the outer side of your elbow.
Surgery may be recommended if other treatments have not been successful and your pain is severe.
It is normally performed under general anaesthetic using elbow arthroscopy whereby a small camera called an arthroscope is inserted into your elbow joint through a small cut in the skin. The tendon for the ECRB is located and the damaged part removed. This procedure aims to decrease your pain and improve your symptoms.