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Conditions & Treatments

Here at Snibbe Orthopedics, we are advocates for educating our patients about your condition and the various treatment options available to you. Please click on the conditions below for detailed explanations and the courses of treatment for each.

This information can assist in diagnosing your orthopedic issue. However, please keep in mind that this information is intended for educational purposes only. In order to fully assess your injury, a comprehensive history and physical exam must be performed by Dr. Snibbe. We encourage you to come into our office to meet with Dr. Snibbe and discuss all available treatment options together.

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. You will find answers to the most commonly asked questions for each procedure, as well as a timeline for your recovery.

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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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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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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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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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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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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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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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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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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Rotator Cuff Arthropathy

Rotator cuff arthropathy is a condition resulting from long-standing rotator cuff tears in the shoulder. Patients develop a severe loss of motion of the arm and weakness and will experience difficulty and pain with lifting, pushing, and pulling motions. There are both non-operative and surgical treatments for this condition.

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SLAP / Labrum Tear

The labrum is a pad of cartilage that lines the shoulder joint. Commonly, patients will injure the labrum as a result of repetitive motion such as throwing or swimming. A “SLAP” tear is a frequently used term to describe a tear that extends from the front of the back of the labrum. Treatment for labral tears involves medications, physical therapy, and possibly arthroscopic surgery.

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Rotator Cuff Tear / Tendonitis

Rotator cuff tendonitis describes the inflammation of the rotator cuff muscles in the shoulder and is often caused by repetitive pushing, pulling, or heavy lifting activities. Tendonitis can lead to tears of the rotator cuff and a person may develop weakness in his/her arm because of the tear. Rotator cuff tear and tendonitis are treated with physical therapy, medications, and sometimes arthroscopic surgery.

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Osteoarthritis (OA) of the Shoulder

Osteoarthritis of the shoulder is the loss of cartilage that covers the ball and socket of the shoulder joint. Patients will experience stiffness, pain in the shoulder, upper arm, and neck and can often have trouble performing over head activities or lifting heavy items. Treatment for shoulder osteoarthritis includes physical therapy, medications, injections, and possibly surgery.

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Shoulder Instability

Shoulder Instability is a condition that occurs as a result of recurrent shoulder subluxation or dislocation. Patients will comment that his/her shoulder feels like it is popping in and out of the socket. Treatment for shoulder instability is dependent on the age of the patient and the type of activity they participate in.

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Rotator cuff being pinched with resulting inflammation

Shoulder Impingement

Shoulder impingement, also known as swimmer’s or thrower’s shoulder, occurs when the rotator cuff is pinched and becomes inflamed. Patients experience pain with overhead activity, reaching, pushing, or pulling motions, as well as pain at night. Impingement is often treated with conservative means including physical therapy and medications, etc.

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Anatomy of Biceps Tendonitis.

Biceps Tendonitis

Biceps tendonitis is an inflammation of the upper part of the biceps tendon. This is common in people who perform repetitive overhead activities or repetitive lifting. Pain is usually sharp and felt in the front of the shoulder. Treatment often includes medications, injections, and physical therapy.

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Biceps Tendon Rupture at Shoulder

A ruptured biceps tendon describes when the long head of the biceps muscle is pulled from its attachment at the shoulder or the elbow. This can happen as a result of lifting a heavy item or a jerking motion while your arm is flexed. Most commonly a patient will notice a deformity of the biceps muscle where there is an abnormal bulge in the arm.

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Adhesive Capsulitis

Adhesive Capsulitis is a condition that describes the loss of motion of the shoulder. Commonly referred to as “frozen shoulder,” patients with this condition experience a significant amount of shoulder stiffness, loss of motion, and pain. Treatment for frozen shoulder often includes medications, physical therapy, and sometimes surgical is necessary.

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