J Korean Med Assoc.  2014 Aug;57(8):667-678. 10.5124/jkma.2014.57.8.667.

Update in surgical treatment of shoulder injuries

• Lhee SH
• Chung MS
• Kim JS
• Lee DY

• KMID: 2194917
• DOI: http://doi.org/10.5124/jkma.2014.57.8.667

Abstract

Increased life expectancy, combined with advancements in medicine, has given rise to an increased prevalence of shoulder injuries. Additionally, the recent social trend in Korea of participation of younger generations in sports activities has also contributed to this increased prevalence. Many healthcare institutions, however, are performing surgery for shoulder injuries without thorough consideration of the complete clinical picture. Only a few of these injuries require surgery, and most of them can be treated and improved with conservative management. The need for surgery should be decided in conjunction with the consideration of the patient's age, living environment and level of physical activity. Here, we give a brief introduction to indications and methods for surgical treatment of shoulder injuries such as rotator cuff injuries, calcifying tendinitis, shoulder instability, osteoarthritis of the glenohumeral joint, and adhesive capsulitis.

Keyword

Shoulder; General surgery; Rotator cuff; Osteoarthritis; Bursitis

MeSH Terms

Bursitis
Delivery of Health Care
Family Characteristics
Korea
Life Expectancy
Motor Activity
Osteoarthritis
Prevalence
Rotator Cuff
Shoulder Joint
Shoulder*
Sports
Tendinopathy

Figure

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  Figure 1 (A) Normal shoulder anatomy. (B) Adhesive capsulitis anatomy.

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  Figure 2 Arthroscopic capsular release. Thickened capsule.

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  Figure 3 Subacromial bursitis.

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  Figure 4 Open acromioplasty.

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  Figure 5 Arthroscopic acromioplasty.

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  Figure 6 Rotator cuff repair using suture-anchor.

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  Figure 7 Single-row rotator cuff repair.

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  Figure 8 (A) Massive rotator cuff tear. (B) Suture-bridge repair of rotator cuff.

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  Figure 9 (A) Subscapularis tear. (B) Arthroscopic subscapularis repair based on Lhee's technique.

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  Figure 10 (A) Cuff tear arthropathy . (B) Reverse total shoulder arthroplasty state.

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  Figure 11 Schematic image of arthroscopic Bankart repair.

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  Figure 12 Arthroscopic Bankart repair state.

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  Figure 13 (A) Bankart lesion & Hill-Sachs lesion. (B) Bankart repair state and Remplissage.

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  Figure 14 Arthroscopic remplissage procedure.

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  Figure 15 (A) Preoperative state of Latarjet procedure. (B) Postoperative state of Latarjet procedure.

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  Figure 16 Latarjet procudure postoperative X-ray. (A) Scapular-Y view, (B) anteroposterior view and (C) axial view.

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  Figure 17 Anteroposterior view of glenohumeral joint arthritis.

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  Figure 18 Total shoulder arthroplasty.

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  Figure 19 (A) Calcific deposit in rotator cuff tendon. (B) Decompression of calcium.

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