Shoulder and elbow treatment at Boston West Hospital
Your shoulder and elbow joints are made up of bones, cartilage, synovial membrane, muscles and tendons. These joint components work together to enable their smooth movement but they can be subject to injury, overuse, wear and tear or disease such as fractures, cartilage damage, tendon tears, instability, osteoarthritis, and rheumatoid arthritis.
Your shoulder is known as a ball and socket joint and allows the highest freedom of motion in the body. Your elbow joint is a hinge joint where your bones can only move along one axis to flex or extend.
Shoulder and elbow surgery is recommended to relieve pain and to repair or restore your shoulder or elbow so that you can regain full functionality.
Boston West Hospital offers shoulder and elbow patients easy access to appointments, modern diagnostic facilities (at Fitzwilliam Hospital) and treatment including surgery and physiotherapy as required. We have highly experienced shoulder and elbow surgeons who work alongside consultant radiologists, chartered physiotherapists, and professional and qualified orthopaedic nurses to provide a cohesive service for finding out the cause of your pain and delivering the latest appropriate treatments.
Day-case surgery is performed at Boston West Hospital and more complex operations are carried out at our nearby sister hospital, Fitzwilliam Hospital.
Shoulder and elbow arthroscopy
Arthroscopy is a keyhole procedure used to look inside your joint using a thin tube with a light and camera on the end so that images can be sent to your surgeon’s monitor or eyepiece. Shoulder and elbow arthroscopy can diagnose your shoulder or elbow problem and is often used to treat the condition at the same time.
Shoulder arthroscopy can be used to:
- Repair rotator cuff
- Remove loose pieces of bone and cartilage
- Remove bone spurs or inflamed tissue
- Remove or repair the labrum
- Repair ligaments
- Repair recurrent shoulder dislocation
Elbow arthroscopy can be used to remove loose pieces of bone and cartilage and bone spurs and treat:
- Tennis elbow
- Osteoarthritis (wear and tear arthritis)
- Rheumatoid arthritis (inflammatory arthritis)
- Osteochondritis dissecans (loose piece of bone)
- Scar tissue to offer a greater range of motion
Rotator cuff repair
Your rotator cuff is a supporting shoulder structure that consists of muscles and tendons that attaches your arm to your shoulder joint. A rotator cuff stabilises your humerus (upper arm bone) in your shoulder socket and allow your shoulder joint to rotate.
An injury of your rotator cuff is a tear or inflammation of the rotator cuff tendons in your shoulder. The tear can be:
- A partial rotator cuff tear – an incomplete tear of your rotator cuff. These are treated with a debridement which is tidying up, trimming and smoothing down your rotator cuff.
- A complete rotator cuff repair – involves stitching the torn tendon back onto the edge of your shoulder joint where it has detached.
Rotator cuff repair surgery is most often performed arthroscopically. Sometimes open surgery is required. Your surgeon will advise you on their recommended procedure for your rotator cuff repair surgery.
Dislocated shoulder surgery
If your upper arm pops out of your shoulder socket, it is known as a dislocated shoulder. Your shoulder joint is easy to dislocate as the socket is shallow.
Repeated dislocations, called shoulder instability, and tissue or nerve damage due to a dislocation, will often be recommended for surgery to reduce your risk of dislocations continuing to happen and to repair damaged tissue.
Dislocated shoulder surgery is performed under general anaesthetic. Usually your surgeon will use arthroscopic surgery but they may recommend open surgery if they need to move your shoulder bones to avoid any further dislocations.
Shoulder replacement surgery
Shoulder replacement surgery is performed if you have shoulder pain and you are struggling to perform daily activities. These symptoms may be due to osteoarthritis, rheumatoid arthritis, or an injury that has brought on arthritis, a severe fracture or arthropathy (arthritis and cartilage destruction) caused by a rotator cuff tear.
Shoulder replacement surgery involves removing and replacing damaged parts of your shoulder. Your surgeon may perform a:
- Partial shoulder replacement – also called hemiarthroplasty, that replaces part of your shoulder joint with an artificial component (often the ball part).
- Total shoulder replacement surgery – also known as shoulder arthroplasty, that attaches an artificial ball and socket.
- Reverse shoulder replacement – involves switching the places of a ball and socket with each other with artificial parts.
Elbow replacement surgery
Total elbow replacement surgery is performed to relieve elbow pain and an inability to move that happens due to rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, a fracture and elbow instability.
In total elbow replacement surgery your surgeon replaces your damaged or worn out elbow joint with a new artificial one that is made up of a metal and plastic hinge and two metal stems.
A partial elbow replacement may be recommended if only part of your elbow joint needs replacing. Your orthopaedic surgeon will review the most appropriate treatment option for your needs.
Tennis elbow is also called lateral epicondylitis and generates pain on the outer side of your elbow. It happens when a muscle tendon on the outside of your elbow becomes inflamed and irritated. This is often due to repeated strain of your extensor carpi radialis brevis (ECRB) muscle. It can occur in tennis players but other activities that repeatedly stress your elbow joint can cause tennis elbow too such as decorating.
If you have severe pain or other conservative treatments haven’t worked then your surgeon may recommend surgery to alleviate your pain and symptoms. This is performed under general anaesthetic using elbow arthroscopy. An arthroscope (thin tube with a camera) is inserted into your elbow joint through a small incision in your elbow skin. Your surgeon will locate the tendon for your ECRB and remove the damaged part