After patients have had surgery, we prefer to instruct them in a home rehabilitation program without the aid of a physical therapist. This assures us that the exercises are appropriate and the patient is less likely to be confused by…
Ultrasound (US) is an excellent imaging modality to diagnose rotator cuff and biceps disorders, but it is by no means the perfect imaging modality for the shoulder. However, there are several other shoulder imaging modalities, such as magnetic resonance imaging…
Arthroscopic techniques are rarely used in the treatment of shoulder fractures. However, arthroscopy may be beneficial in some cases of greater tuberosity fracture, coracoid fracture, fracture of the glenoid rim, and displaced intra-articular humeral head malunion. These procedures can be…
One of the most painful acute conditions affecting the shoulder is calcific tendinitis. Patients experience a sudden, atraumatic onset of severe pain that is present at rest and increases with any shoulder movement. The pain is often severe enough to…
Acromioclavicular (AC) joint pathology can be divided into conditions that cause pain or conditions of instability that may cause pain or compromise function. AC joint pain can be secondary to a specific injury, from repetitive minor trauma, or as part…
The biggest problem with the arthroscopic treatment of massive rotator cuff tears is the possibility of misdiagnosis. Often, a massive tear is retracted and appears irreparable, but after soft tissue release, the defect is partially or completely reparable. On the…
It is not clear that there is a specific definition for a massive rotator cuff tear, but it can be loosely defined as one that involves two complete tendon tears or one that is as greater than 5 cm in length…
An arthroscopic rotator cuff repair consists of the following elements: glenohumeral joint inspection, subacromial space inspection, partial bursectomy, assessment of rotator cuff tendon reparability, identification of tear geometry, coracoacromial ligament (CA) management, acromioplasty, greater tuberosity repair site preparation, anchor placement,…
Partial-thickness rotator cuff tears constitute an interesting and difficult group of shoulder lesions. In large part, the difficulty stems from terminology: we use the phrase partial-thickness rotator cuff tear to describe the anatomic end result of several different pathophysiologic pathways.…
Rotator cuff tendon lesions of the subacromial space include tendinosis (impingement syndrome), partial-thickness tears, and full-thickness tears. Full-thickness tears come in all patterns and sizes and can be further classified as being fully reparable, partially reparable, or irreparable, depending on…