Shoulder

Shoulder instability

Shoulder instability occurs when the structures that surround the shoulder joint cannot adequately maintain the ball within its socket. These structures are the joint capsule, cartilage ring (labrum) and various ligaments. Instability usually occurs after injury to the shoulder and can cause feelings of abnormal movement or pain in the shoulder long after the injury. If the shoulder joint remains unstable and return to sport or other activities are not possible surgical stabilisation of the joint may be necessary.

Shoulder arthroscopy
Latarjet axillary
Latarjet

Rotator cuff surgery

The rotator cuff refers to the tendons of the four muscles that are responsible for initiating movement of the shoulder and help to maintain the ball within its socket. As we age the tendons become thinner and weaker and are susceptible to tears. Small tears and inflammation can cause pain and larger tears can result in a complete loss of certain movements. Rotator cuff tears are often associated with other causes of pain such as biceps tendon pain. The pain caused by these injuries should first be managed with injections and physiotherapy. If this initial non-surgical treatment is unsuccessful then surgical management in the form of arthroscopy (“keyhole” surgery) with tendon trimming and repair is indicated. If there are other sources of pain, such as the biceps tendon, these can be managed at the same time.

Total and reverse total shoulder replacement

A total shoulder replacement (TSR) is a surgical procedure in which both the damaged socket and ball of the shoulder joint are replaced with artificial parts or prosthesis. The goals of shoulder replacement surgery are to relieve pain, improve function and increase mobility of the shoulder joint. The two main replacement types that are used are a total shoulder and a reverse total shoulder replacement. The shoulder joint is responsible for positioning the arm in space and severe arthritis can cause pain and stiffness. Inability to lift the arm could however be present without stiffness, which is called pseudoparalysis. This is usually due to an associated very large rotator cuff tears. If non-surgical treatment methods are ineffective then joint replacement surgery may be required to improve pain and movement of the shoulder. It is at this point where the decision as to what type of prosthesis is required will need to be made.

Our specialists

Dr James McAllister

Specialist Orthopaedic Surgeon

BSc MBChB H.Dip Orth (SA) FC Orth (SA)

Dr Rian Smit

Specialist Orthopaedic Surgeon

MBChB H.Dip Orth (SA) FC Orth (SA)