The main shoulder problems are synovitis (inflammation) and shoulder injuries such as rotator cuff tendon tear, shoulder dislocation, acromioclavicular osteoarthritis, capsulitis (frozen shoulder), chronic tendonitis, partial tears of the long biceps tendon.
Along with the use of injections (ortokine therapy) for minor injuries of the shoulder in more severe cases may require surgery – open or shoulder arthroscopy – minimally invasive surgical procedure that is used by our orthopedic surgeons to visualize, diagnose and treat problems inside a joint.
Leading doctors for shoulder treatment in Israel
Dr. Maman – Head of Shoulder Surgery Unit, Orthopaedics Department, Sourasky Medical Center, Tel Aviv (Ichilov). Orthopedic surgeon, specialist in shoulder treatment and sports injuries.
Dr. Maman is in the Forbes list of the best Israeli doctors.
Upon review of X-ray and MRI images of shoulder as well as physical examination, the physician makes a conclusion regarding the treatment.
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Shoulder treatment
Arthroscopic subacromial decompression. The operation is applied at acromioclavicular syndrome (pain in the shoulder joint compression of the rotator accompanied not only pain but also limited mobility of the shoulder) and aims to increase the size of the subacromial space and reducing the load on the muscles. When this incision is bonded bone spurs (small calcifications) are removed. The procedure is performed through two or three 5mm puncture, after which leaves no traces or scars. Our experience also shows that at 3 week arm has full range of motion, but with a little discomfort when you move your hand over your head. Three months after surgery symptoms are eliminated by about 80 %. Full recovery may take 6 to 9 months if the proper physical therapy to help relieve pain and restore your back muscles.
Bankart Surgery. This procedure is a minimally invasive surgical technique for the correction of habitual dislocation of shoulder. During the procedure the torn ligament restored and attached to the glenoid lip, causing the shoulder again can function normally. Operation also minimizes unwanted joint stiffness. This operation can be done in two ways – arthroscopy or using open surgical techniques. Method of operation is determined by the surgeon after a personal examination of the patient as well as X-rays or CT scans.
Rotatory Cuff Repair. This operation is performed to restore tendon rupture shoulder. The procedure can be performed as an open manner and using arthroscopy, in which the surgeon inserts through a small puncture in the shoulder an endoscopic camera, and evaluates the status of joint damage. After evaluation of shoulder surgeon places the camera above the rotator cuff (subacromial space) and using endoscopic scalpel inserted through additional punctures, cleans inflamed or damaged tissue, removing bone spurs and osteophytes. Then torn tendon attached to the bone sutures (Special tools called Suture anchors). These sutures dissolve gradually over time and require no additional intervention. Recovery from such a procedure may take 3 – 6 months, depending on the size of the gap and other factors. Perhaps for 4 – 6 weeks after surgery arm should be located in the shroud (shoulder immobilizer), which makes the shoulder fixed and thus accelerates its recovery.
Shoulder Cartilage Repair. The procedure used in cases of wear (erase) the cartilage of the shoulder due to arthritis, avascular necrosis or rheumatoid diseases as an alternative to shoulder replacement. The possibility of its implementation is determined by surgeon in each case individually after examining the patient. This minimally invasive arthroscopic surgery at which the cartilage resurfacing its correction preserving bone and joint natural tissue. Once the bone is surgically polished surface it is put Artifical cartilage, which contributes to the restoration of normal function of the shoulder joint. The advantages of this procedure are not applicable to the osteotomy (bone removal) as well as less invasive interventions in the body, shorter operation time and therefore rehabilitation.
Distal Clavicle Excision. This operation is performed in cases of excessive degeneration of the clavicle or shoulder tip (acromion) or arthritis of the acromioclavicular joint. During the procedure removes a small piece of the end of the clavicle with the worn surface of the joint. It is this piece that causes pain in the shoulder when moving hand. Later bone restored and with it the scar tissue allowing the acromion move more smoothly and relatively painless. Operation for excision of the distal clavicle usually takes one to two hours, carried out under general anesthesia, but sometimes under local anesthesia. Surgery can be performed either as an open procedure through one incision is about 3-4 inches, or as an arthroscopic procedure through several small punctures about one centimeter long, in which physician enters a small chamber and the necessary micro – tools.
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