Shoulder - Porter Medical Center
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Orthopedics
Porter Orthopedics provides leading orthopedic care in Middlebury, along with resources and access to The UVM Health Network. Meet our orthopedic providers and learn more about the services they offer.

Shoulder

Shoulder

Shoulder pain is very common, which is not surprising since you use your shoulders for so many common tasks throughout the day. There are a number of causes for shoulder pain, including arthritis, trauma, injury, sprains and strains, sports injuries, and fractures.

Our orthopedic surgeons treat a broad range of athletic, degenerative and traumatic shoulder disorders, and they employ the latest in non-surgical and surgical techniques to diagnose and treat these problems, including shoulder arthroscopy and rotator cuff repair. 

We will partner with you to develop the treatment plan that works best for your condition.

Rotator Cuff Injury and Repair

Rotator cuff injuries can be sustained from sports, falls, or other traumatic injuries. As a result, problems such as tears, tendinitis and bursitis can occur. When you suffer from a rotator cuff injury, our experienced team at Porter Medical Center can determine the cause of pain to develop the most effective personalized treatment plan. Through the different procedures available, we strive to accomplish the following:

  • Alleviating chronic shoulder and arm pain
  • Preventing additional shoulder damage
  • Minimizing the size of a rotator cuff tear
  • Helping to retain shoulder and arm mobility

The course of action for treating rotator cuff injuries involves nonsurgical or surgical treatment, followed by physical therapy for proper shoulder rehabilitation. The nonsurgical treatments are used to improve overall shoulder function and relieve pain. This involves cutting back on aggravating activities, limiting mobility with a sling, anti-inflammatory medications, cortisone injections, or physical therapy. Most often however, shoulder strength and mobility are best restored through surgery.

Rotator cuff surgery is performed to reattach the damaged tendon to the head of the upper arm bone or humerus. Additionally, surgical procedures can repair osteoarthritis damage, soft tissue tears and bone spurs. If pain persists and symptoms from your injury continue for 6 to 12 months, surgery is recommended to restore shoulder functionality and strength. Surgeons will perform the procedure that will yield the best results. These are the most common performed for repair:

  • Arthroscopic surgery –This minimally-invasive procedure involves a surgeon using a small camera called an arthroscope, to guide tiny surgical instruments to the area where the tear needs to be fixed.
  • Open repair –For larger, more complex tears, this method of repair is recommended. A 1- to 2-inch incision is required, allowing a surgeon to detach the shoulder muscle or deltoid, and have access to repairing the torn tendon.
  • Mini-open repair –This procedure combines a combination of arthroscopic and open repair surgery. Once an incision is made, a surgeon inserts the arthroscope to assess the damage. They can then perform the necessary repairs by removing bone spurs and fixing the rotator cuff.

Shoulder Arthroscopy

Shoulder Arthroscopy is a minimally invasive procedure used to treat shoulder problems such as rotator cuff tears, instability, AC joint arthritis and labral tears. To be considered a candidate for shoulder arthroscopy, patients typically have AC joint arthritis, shoulder dislocations, rotator cuff tears, a glenoid labrum tear, cartilage injuries or other kinds of shoulder fractures. The exact procedure of a shoulder arthroscopy will vary for each person, but in general, it begins with general or regional anesthesia. A small incision around the shoulder is then made, so an arthroscope can be inserted to display real-time images of the area. The surgeon will inspect the damaged tissue or joint and surrounding area. Specialized instruments are then used to repair and remove damaged tissues. The instruments are removed and the incision is closed.

Post-surgery, you’ll most likely have to wear a sling depending on the nature of your procedure. From there it’s recommended you undergo physical therapy to regain full functionality of your shoulder. The Porter Medical Center surgeons will ensure that a personalized physical therapy plan is put together for you, giving you the most successful recovery possible.

Shoulder Replacement

If you’re suffering from arthritis, a rotator cuff tear, or fractures from an injury, a shoulder replacement could be the recommended form of treatment. The ultimate goal of the Porter Medical Center team is to relieve you of chronic shoulder and arm pain, prevent any additional shoulder damage from occurring, and help you regain full shoulder and arm mobility. If pain doesn’t improve with nonsurgical methods, the best form of action for a full recovery is shoulder replacement.

To determine the best treatment plan, X-rays, MRIs, CT scans or ultrasounds are used to fully examine the extent of the injury. Once the nature of the damage is determined, the surgery involves the replacement of damaged shoulder parts with artificial components called prostheses. Surgeons could be replacing the head of the humerus bone in your upper arm or both the ball and socket. The following surgery options will be considered upon examining your injuries:

  • Total shoulder replacement –This is most common if your shoulder damage is due to osteoarthritis. A surgeon places a smooth plastic cup into your arm socket to replace the head of your upper arm bone. The prosthesis is a metal ball attached to a stem that fits into the plastic socket.
  • Reverse total shoulder replacement –This procedure is recommended if your rotator cuff tear is irreparable, you have severe arthritis, or a previous shoulder replacement that’s failed. A plastic socket is placed into the head of your upper arm bone, and a metal-ball-prostheses into your bone socket.
  • Resurfacing total shoulder replacement –For this procedure, a surgeon replaces just the head of the upper arm bone with a cap-like prosthesis.

Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is pain, stiffness and a limited range of movement that occurs in the shoulder. This is a result from overuse, injury, or diseases like diabetes or stroke. Frozen shoulder can be a result of previous shoulder problems if the proper range of motion isn’t restored. Shoulder discomfort progresses slowly over time, as a result of the stiffening of tissues around the joint causing scar tissue to form. Most commonly frozen shoulder occurs in people 40-70 years old, after a surgery or injury, and more often in women and people suffering from chronic diseases.

Frozen Shoulder Treatment

To begin the treatment process, doctors use an X-ray to determine what specifically is causing the condition. The first form of treatment is nonsteroidal anti-inflammatory drugs (NSAIDS) and the application of heat. This is followed by gentle stretching to reduce the pain. Another form of action is ice and corticosteroid injections to minimize swelling. Although it takes a year or longer to improve the symptoms of frozen shoulder, with the proper physical therapy, your range of motion can be restored. In the event that these treatments aren’t effective, surgery is recommended to help loosen the tightened tissues around the shoulder. These are the two common surgeries performed:

  • Manipulation under anesthesia –During this procedure, you’ll be put to sleep and specialists will move your arms into specific positions that help to stretch out the tight tissue.
  • Arthroscope surgery –An arthroscope is used to cut through the tight tissue and scar tissue. This procedure can be done in conjunction with the manipulation under anesthesia.

Get the personalized care you need. Call today to request an appointment at 802-388-3194.