Speciality
Shoulder
The human shoulder is an epitome of engineering, granting us the widest range of motion among all joints in our body. From reaching out to grasp the high notes of life to embracing our daily routines, the shoulders play a pivotal role. However, a hiccup in its normal functioning can cascade into a myriad of limitations, hindering not just athletic pursuits or overhead work tasks, but even the simple joys of daily activities such as combing your hair, donning a shirt, flicking a light switch, or finding a comfortable position to sleep.
The spectrum of medical ailments that could besiege the shoulder is broad, each bringing along a toll of pain and a dent in functional capacity. The ordeal of enduring a compromised shoulder can indeed be daunting, casting long shadows over one’s quality of life.
AC Joint Injuries
At Dr. Nagraj Shetty’s practice, we specialize in comprehensive care for AC joint injuries, recognizing their impact on shoulder function and overall well-being. Whether stemming from sports-related incidents or degenerative conditions, AC joint injuries demand personalized attention and advanced treatment modalities. Dr. Shetty employs a multidisciplinary approach, combining state-of-the-art diagnostic techniques with evidence-based interventions to address each patient’s unique needs effectively.
The Arthroscopic Dog Bone Reconstruction with Hamstring Graft Augmentation with Internal Brace
The Arthroscopic Dog Bone Reconstruction procedure represents a cutting-edge approach in treating shoulder instability. It’s particularly beneficial for patients who have experienced glenoid bone loss, a condition that often results from recurrent shoulder dislocations. By utilizing a hamstring graft along with an internal brace, this procedure aims to restore the original anatomy of the glenoid, thereby enhancing shoulder stability and function.
Procedure Overview: The surgery is carried out arthroscopically, which is a minimally invasive technique. The key steps include:
Preparation: The surgeon prepares the shoulder and the hamstring graft, which is harvested from the patient or obtained from a tissue bank.
Glenoid Preparation: The glenoid bone (the socket part of the shoulder joint) is prepared to receive the graft.
Graft Placement: The hamstring graft is placed onto the glenoid to augment the bone loss. It’s secured using a Dog Bone implant, which is fixed to the bone.
Internal Brace Augmentation: An internal brace, made from strong suture material, is placed to provide additional support to the graft, enhancing stability and promoting healing.
Final Inspection: The surgeon inspects the joint to ensure correct graft placement and stability before closing the incisions.
Arthritis Of Shoulder
Stemless Shoulder Replacement
Unlike traditional shoulder replacement, a Stemless Shoulder Replacement doesn’t involve the use of a stem within the humerus. Instead, the prosthesis is implanted directly into the humeral bone. This approach aims to preserve more bone stock, which can be particularly beneficial for younger or more active patients. The procedure may result in a quicker recovery and easier revision surgery, if necessary in the future.
Anatomical Total Shoulder Arthroplasty
Anatomical Total Shoulder Arthroplasty is a surgical procedure that replaces the damaged parts of the shoulder joint with prosthetic components. The goal is to restore the natural anatomy of the shoulder. It’s usually recommended for patients with shoulder arthritis where the rotator cuff tendons are intact. The procedure aims to alleviate pain and restore function and range of motion to the shoulder.
Reverse Total Shoulder Arthroplasty
Unlike the Anatomical Total Shoulder Arthroplasty, the Reverse Total Shoulder Arthroplasty switches the ball and socket parts of the shoulder joint. This procedure is often recommended for individuals with a completely torn rotator cuff, cuff tear arthropathy, or severe shoulder arthritis. By reversing the natural anatomy of the shoulder, it allows other muscles to take over the function of the damaged rotator cuff, improving the shoulder’s stability and function.
CAM Procedure (Comprehensive Arthroscopic Management)
The CAM procedure is a minimally invasive arthroscopic technique aimed at addressing various shoulder joint issues without resorting to shoulder replacement. It may include debridement, removal of loose bodies, capsular release, and other procedures to alleviate pain and improve joint function. It’s often recommended for younger patients with post-traumatic arthritis or those who wish to delay or avoid shoulder replacement.
Biceps Tendon Injuries
Arthroscopic Biceps Tenodesis
The long head of the biceps tendon is a common source of shoulder pain, and its pathology can often coexist with other shoulder problems such as rotator cuff tears and shoulder impingement. Arthroscopic Biceps Tenodesis is a surgical procedure that addresses issues with the biceps tendon in the shoulder. By securing the tendon to a stable anchor point, usually on the humerus, it alleviates discomfort and preserves the function of the biceps muscle.
Procedure Overview:
- Preparation: The procedure begins with the patient being placed under anesthesia. The surgeon then makes small incisions around the shoulder area to access the joint.
- Arthroscopic Evaluation: Initially, an arthroscopic examination is conducted to assess the extent of the damage and the overall condition of the shoulder joint.
- Tendon Release and Preparation: The surgeon releases the biceps tendon from its original attachment point. The tendon is then prepared for reattachment.
- Tendon Securing: The surgeon creates a small hole in the humerus (Subpectoral Tenodesis) or other anchor points (Other types of Tenodesis) to secure the tendon. The tendon is then anchored securely using suture anchors.
- Closure: Once the tendon is securely anchored, the incisions are closed, and the area is bandaged.
Recurrent Dislocation Shoulder
Arthroscopic Bankart Repair
This procedure is typically performed to address recurrent shoulder dislocations. The Bankart lesion is a specific injury to a ligament in the front part of the shoulder due to dislocations. Arthroscopic Bankart Repair involves reattaching this ligament using minimally invasive techniques.
Arthroscopic Iliac Crest/Scapular Spine Bone Grafting
This procedure involves harvesting bone from the iliac crest or scapular spine and grafting it to the shoulder area to address bone loss or to augment bone stock, often associated with recurrent shoulder instability.
Latarjet Procedure
This surgical procedure is used to treat recurrent shoulder dislocations, especially in cases with significant bone loss. It involves transferring a small piece of bone with an attached tendon from the scapula to the front of the shoulder joint.
Revision Instability Surgery
This procedure is undertaken when initial surgery to correct shoulder instability was unsuccessful. It aims to address the causes of failure and to stabilize the shoulder.
Arthroscopic/Open Glenoid Fracture Fixation
This procedure aims to repair fractures of the glenoid, which is the socket part of the shoulder joint. It can be performed arthroscopically or through an open surgical approach depending on the severity and complexity of the fracture.
Open Capsular Shift Surgery
This procedure is used to treat multidirectional instability of the shoulder. It involves tightening the shoulder joint capsule to provide better stability.
Open Reduction of Locked Anterior and Posterior Dislocation
This procedure is used to treat a dislocated shoulder, where the humeral head is repositioned back into the shoulder socket. It’s called open reduction as it requires an open surgical approach.
McLaughlin Procedure
This procedure is typically performed for recurrent posterior shoulder dislocations. It involves transferring the subscapularis tendon to the posterior defect in the humeral head to prevent further dislocations.
Fracture
Open Reduction Internal Fixation (ORIF)
Open Reduction Internal Fixation is a surgical procedure used to repair severely broken bones within the shoulder joint. The term “open reduction” refers to the surgical opening of the area to set the bones in their proper place, while “internal fixation” refers to the use of hardware such as screws, plates, or rods to keep the bones stabilized during the healing process. This procedure aims to restore the normal anatomy of the shoulder joint, enable early mobility, and prevent complications associated with severe fractures.
JUST UNIC
JUST UNIC is a specific type of prosthesis used in shoulder surgery. It’s designed to replace the articulating surface of the shoulder joint, particularly the humeral head, while preserving as much of the natural bone and joint structure as possible. This system can be used in various shoulder conditions including arthritis, avascular necrosis, or certain fractures.
Percutaneous Pinning
Percutaneous Pinning is a minimally invasive procedure used to stabilize fractures or dislocations in the shoulder. Under X-ray guidance, pins are inserted through the skin into the bone to hold the fractured or dislocated bones in place until they heal. This method aims to provide stability to the joint with minimal surgical intervention, allowing for a shorter recovery period and less post-operative pain compared to open procedures.
Hemiarthroplasty
Hemiarthroplasty is a surgical procedure that replaces the damaged or diseased portion of the shoulder joint, typically the humeral head, with a prosthetic implant, while leaving the other part of the joint intact. This procedure is often employed in cases of severe shoulder fractures or arthritis when only one part of the shoulder joint is damaged. The goal of hemiarthroplasty is to alleviate pain, restore function, and improve the range of motion in the shoulder.
