Diagnoses & Treatments

Dr. Snibbe and his team want you to have a thorough understanding of the surgery you are having as well as the steps you will go through before, during, and after surgery. Thus, we have put together this information, which you can use at any point to ensure a smooth progression through your surgical care. For each procedure, you will find answers to the most commonly asked questions for each procedure, as well as a timeline for your recovery.

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Filter Conditions:     AllShoulderElbowHipKnee
ShoulderArthroscopyFeatured

Arthroscopic Distal Clavicle Excision

This procedure involves removing the end of the clavicle, which forms the AC joint. This will alleviate pain and loss of motion caused by impingement and arthritis. Your body will produce scar tissue where the bone is removed, and your pain will resolve since there is no longer bone rubbing on bone. This procedure is often performed with a subacromial decompression.

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ShoulderArthroscopyFeatured

Arthroscopic Labral Repair

Shoulder arthroscopy with labral repair involves first, cleaning out the shoulder of any debris or inflamed tissue. During this time, the surgeon will also remove any frayed or damaged labral tissue. The torn piece of labrum is repaired using strong sutures to secure the labrum back to its appropriate position on the socket of the shoulder. This recreates the stability that the labrum provides for the shoulder joint and resolves the pain, clicking, and feeling of the shoulder “popping in and out” often associated with a labrum tear.

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ShoulderArthroscopyFeatured

Arthroscopic Rotator Cuff Repair

Shoulder arthroscopy with rotator cuff repair involves first, cleaning out the shoulder of any debris or inflamed tissue. During this time, the surgeon will also remove any frayed or damaged tissue of the rotator cuff. Using multiple strong sutures the rotator cuff is secured back to its appropriate position on the ball of the shoulder joint (humeral head).

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ShoulderArthroscopyFeatured

Arthroscopic Subacromial Decompression

Shoulder arthroscopy with a subacromial decompression involves first, cleaning out the shoulder of any debris or inflamed tissue. Then, by using a small shaver device, the undersurface layer of the acromion is removed. The space below the acromium where the rotator cuff passes is thus made wider. By doing this, the rotator cuff can freely pass without rubbing on bone and becoming inflamed or impinged.

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ShoulderArthroscopyFeatured

Arthroscopic Capsular Release

In order to resolve the stiffness associated with adhesive capsulitis, capsular release (cutting of the tissue that encompasses the joint) is performed to break up the inflamed scar tissue in the shoulder and allow the shoulder to move more freely. Depending on how stiff the shoulder is prior to surgery, a manipulation of the shoulder may be performed, which involves moving the shoulder around through all ranges of motion to help alleviate the stiffness in the shoulder.

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Latarjet-xray-index

Latarjet

Latarjet is an open procedure for the shoulder where the coracoid process of the shoulder is cut. The bone that is cut is then placed over the front of the shoulder joint and secured with a screw. This piece of bone now acts as a wall in the front of your shoulder that will stabilize the shoulder joint and prevent any instability or dislocation from occurring.

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Open Biceps Tendon Repair

Biceps tenodesis is an open procedure, meaning it requires either one or two incisions. Reattachment at the shoulder is done through an approximately half-inch incision on the inside of the arm close to the axilla. For reattachment at the elbow, a two-incision approach is utilized. At the elbow, the first incision is at the crease where the elbow bends. The second incision is on the back of the forearm. Regardless the number of incisions, the surgery is similar. First the ruptured tendon is located by the surgeon. Once located, the end of the tendon is cleared of any damaged tissue so the tendon has a fresh edge. Then the end of the tendon is reattached down to the bone with strong suture known as Fiberwire. If necessary, an additional screw or peg may be inserted for extra fixation of the tendon to bone.

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reverse-total-shoulder

Reverse Total Shoulder Arthroplasty

Reverse total shoulder arthroplasty involves removing the damaged cartilage that lines the joint and replacing it with a metal implant. In this procedure, the ball of the shoulder is replaced with a metal socket, and the socket of the shoulder is replaced with a metal ball. The implants used are made of titanium or cobalt chrome. They are often cemented in place for additional stability. Patients are often placed in a sling for comfort after surgery. With the reverse total shoulder, you will use accessory shoulder muscles such as the deltoid to raise your arm in the absence of the rotator cuff.

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total-shoulder

Total Shoulder Arthroplasty

Total shoulder arthroplasty involves removing the damaged cartilage that lines the joint and replacing it with a metal implant. In this procedure, the ball of the shoulder is replaced with a metal ball and the socket of the shoulder is replaced with a metal socket and plastic liner. The implants used are made of titanium or cobalt chrome. They are sometimes cemented in place for additional stability.

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Open Lateral Epicondylar Release

A lateral epicondylar release is an open procedure often performed through 3–4 cm incision on the outside of the elbow. During the procedure, the common extensor tendon is located and evaluated for any injury or damage. The tendon is split in order to remove damaged and inflamed tissue. The lateral epicondyle (bone) is also debrided in order to remove any scar tissue or inflammatory tissue that has developed as a result of long-term tennis elbow. Once this debridement is complete, the common extensor tendon is secured back to the lateral epicondyle (on the outside of the elbow) with strong suture. This provides a clean, non-inflamed edge now connected to bone, providing the tendon with more stability and less chance for recurrence when the patient resumes normal activities. Following the procedure, the patient is placed in a soft cast to immobilize the wrist and prevent any force applied by the wrist on the repair.

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Open Medial Epicondylar Release

A medial epicondylar release is an open procedure, often performed through a 3–4 cm incision on the inside of the elbow. During the procedure, the tendon that attaches to the inside of the elbow is located and evaluated for any injury or damage. It is common to cut this tendon in order to remove damaged and inflamed tissue. The medial epicondyle is also debrided in order to remove any scar tissue or inflammatory tissue that has developed as a result of long term golfer’s elbow. Once this debridement is complete, the tendon is secured back to the medial epicondyle (on the inside of the elbow) with strong suture. This provides a clean, non-inflamed edge now connected to bone. This provides the tendon with more stability and less chance for reoccurrence when the patient resumes his/her activities. Following the procedure, the patient is placed in a soft cast to immobilize the wrist and not allow for wrist flexion. This is necessary initially so that there is not any force applied by the wrist on the repair.

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Open Triceps Tendon Repair

A triceps tendon repair is an open procedure done through an approximately 5 cm incision on the back of the arm directly above the elbow. First, the ruptured or torn tendon is located by the surgeon. Once located, the end of the tendon is cleared of any damaged tissue so the tendon has a fresh edge. Then the end of the tendon is reattached down to the bone with strong suture known as Fiberwire.

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hipScope

Arthroscopic Iliotibial Band Release

Through a small arthroscopic incision, the IT band can be located on the outside of the thigh. In the procedure, a portion of the IT band is excised so that an opening is created over the greater trochanter. By removing this piece of the IT band, it will no longer get caught on the greater trochanter and thus the snapping sensation will no longer occur.

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hip_FAI_labral_refixation

Arthroscopic Labral Reconstruction

A patient undergoing this procedure will have their labrum reconstructed with use of an allograft (cadaver tissue) or the patient’s own tissue (commonly iliotibial band is used). The reconstruction of a damaged or incomplete labrum is important to recreate the suction seal function of the labrum in the hip joint. This provides the patient with hip stability and resolves pain commonly associated with a labral tear.

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hip_FAI_labral_refixation

Arthroscopic Labral Repair with Osteoplasty of Femoral Neck and Acetabulum

The labrum is repaired using strong suture that is wrapped around the sagging or torn part of the labrum. By using surgical anchors, essentially small plastic pegs that hold the suture in place, the labrum can be resecured to its appropriate position on the rim of the acetabulum. These pegs do not contain metal and will break down and dissolve away over time. The suture will keep the labrum fixed to the rim of the acetabulum, and will help the labrum scar into position. It is common to use two or three of these anchors in a hip arthroscopy with labral repair.

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hipScope

Arthroscopic Partial Iliopsoas Tendon Release

The partial iliopsoas tendon release can be performed arthroscopically. Instead of releasing the tendon completely, which may lead to postoperative weakness, a partial tendon release is preferred. Using a heat device, the tendon is partially released and by doing this, the tendon is lengthened. This lengthening allows the tendon to glide over the hip joint and not snap any further.

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hipScope

Arthroscopic Trochanteric Bursectomy

Through a small incision on the side of the thigh, a tiny shaver instrument is used to clean out the bursa. All of the inflamed, damaged, or frayed tissue is removed. This may be combined with an iliotibial band release, labral repair, and/or osteoplasty of femoral neck and acetabulum.

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proximal-hamstring

Proximal Hamstring Repair

During an open proximal hamstring repair, an approximately 3–5 cm incision is made at the crease of the buttock. Next the damaged hamstring tendon is located and any frayed or damaged tissue is removed. Once a clean edge of healthy tendon is achieved, it is secured using strong suture back to its insertion on the ischial tuberosity of the pelvis.

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Total Hip Arthroplasty

In a total hip arthroplasty, the cartilage that lines the hip joint is a source of pain and is thus removed. The damaged ball of the hip joint is replaced with a metal ball that is attached to a metal stem, which is fitted in the femur. The socket of the hip (acetabulum) is replaced with a metal cup that has a plastic liner.

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Arthroscopic ACL Reconstruction

Prior to ACL reconstruction surgery, a patient must have full range of motion of the knee. Therefore, it is common to be sent for a month of physical therapy prior to surgery in order to regain range of motion.

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Arthroscopic Bursectomy

Arthroscopy with bursectomy usually involves one to two small incisions on the knee. The arthroscope is placed into the bursa along with a small shaving device. This device cleans out the bursa of any debris or inflamed tissue.

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Arthroscopic Meniscus Repair

Arthroscopy of the knee with meniscus repair requires two small incisions in the front of the knee. Once the tear is visualized and deemed repairable, the edges of the torn meniscus are reattached to the body of the meniscus using surgical suture or tacks.

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kneeScope

Arthroscopic Meniscectomy

Arthroscopy of the knee with partial meniscectomy requires two small incisions in the front of the knee. Once the tear is visualized, the torn edges are shaved or bitten away using small instruments. This will leave a smooth edge of the meniscus so the patient can move the knee without any catching or locking sensation.

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procedures-knee-patella-index

Medial Patellafemoral Ligament Reconstruction

This procedure is performed in two parts. Initially an arthroscopy of the knee is done to complete a lateral release. This involves releasing tight tissue on the outside of the knee that is pulling the knee cap out to the side and causing the knee cap to dislocate.

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total-knee

Total Knee Arthroplasty

In a total knee replacement, the damaged cartilage and bone will be removed from your knee joint. A new metal surface will be fixed with cement to the end of the femur (thigh bone) and also to the top of the tibia (shin bone) that make up the knee joint. The surgeon will make sure that the alignment and function of your knee is restored at this point. A plastic spacer is then connected to the tibial component, which recreates the native joint space. The third component of the knee replacement is the knee cap (patella). The back of the knee cap is also fitted with a plastic implant that acts to resurface the back of the knee cap, allowing for smoother flexion and extension of the knee.

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Filter Conditions:     AllShoulderElbowHipKnee

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