Shoulder Reconstructive Surgery

Reconstructive shoulder surgery consists of offering those patients who suffer from pathologies in this joint, different treatments that can range from, open reduction plus fixation with fracture osteosynthesis materials.

Even joint replacements due to loss of the structural and functional anatomy of these joints. In this way, enabling optimal options for the shoulder to regain the degree of functionality that allows the patient to improve their quality of daily life..

In practice, reconstructive shoulder surgery, is an alternative to full replacement. The surgeons procedure, is based on the reconstruction of damaged bone and cartilage, at the ends of the joint bones.

Reconstructive Shoulder Surgery in Bogotá

The shoulder is a highly mobile joint of the body that allows various movements of the arm. It is a ball and socket joint, where the head of the humerus (upper arm bone) articulates with the cavity of the scapula (omóplato) called glenoids. The two articulated surfaces of the bones are covered with cartilage, which prevents friction between moving bones. Cartilage is lubricated by synovial fluid. Tendons and ligaments around the shoulder joint provide strength and stability to the joint.

When cartilage is damaged, the two bones rub against each other and cause pain, joint swelling and stiffness (osteoarthritis).

Total shoulder replacement surgery is done to relieve these symptoms.. In this surgery, the damaged articulated parts of the shoulder joint are removed and replaced with artificial prostheses. Replacement of both the humeral head and socket is called a total shoulder replacement..

Shoulder Reconstructive Surgery colombia

Tratamientos quirúrgico para lesiones de hombro

Rotator cuff tears
Rotator cuff on the shoulder allows a wide range of motion in the shoulder and helps maintain shoulder stability. A common shoulder injury is a torn rotator cuff., which may be a partial tear, a small full-thickness tear or a complete tear of the tendons. Shoulder tears are unlikely to heal on their own for a number of reasons and, Thus, surgical intervention may be required.

The surgical technique used to treat rotator cuff tears is, In most cases, a shoulder arthroscopy through small incisions in the shoulder. With this minimally invasive technique, small surgical instruments are used to repair the rotator cuff, avoiding the need for open surgery.
Surgical treatment for shoulder instability
In an unstable shoulder joint, shoulder ligaments loosen or become unstable as a result of injury or trauma causing the dislocation. In some people, shoulder structure is naturally loose, leading to multiple shoulder dislocations. As it loosens, the head of the upper arm bone (humerus) tends to come out of the cavity, causing a partial or total dislocation. Support structures in the shoulder (ligaments, tendons and cartilage) can be damaged and contribute to instability.

A diagnosis is made through images, exams and various tests of the shoulder and, subsequently, you may need surgical treatment. During your initial consultation, the different types of surgery will be discussed with you, including a Bankart repair and a capsular change.
Shoulder replacement surgery
Patients with arthritis of the shoulder are candidates for partial and total shoulder replacements, involving replacement of the arthritic joint with prosthetics. Treatment options for shoulder replacement include a hemiarthroplasty (replacement of the humeral head or ‘ball’) o total replacement of both ball and socket (glenoide). Other methods of surgery include rejuvenation hemiarthroplasty and reverse total shoulder replacement..

Shoulder surgery can be performed in all age groups, however, not all patients are candidates. Many factors, including the anatomy of your shoulder, the severity of the injury, previous injury, body type and previous surgeries, play an important role in deciding the most appropriate approach for you.
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Shoulder Reconstructive Surgery

Shoulder reconstruction is surgery to stabilize the shoulder joint and prevent recurrent dislocations.. A secondary goal is to restore the greatest possible range of motion and strength..

And shoulder healthy consists of an extremely flexible ball joint supported by soft tissue ligaments. Some patients, especially athletes, suffer repeated shoulder injuries, that can stretch and tear these stabilizing tendons and ligaments.

A Bankart tear is a common injury that can lead to shoulder instability . Repetitive arm movements overhead in sports or weight lifting can cause a Bankart tear., like falling on an outstretched hand. Symptoms include reduced strength, pain, feeling of loosening in the joint, a clicking sound coming from the shoulder joint and arthritis.

Shoulder instability is often caused by a dislocation or subluxation of the shoulder, in which the bone is fully or partially pushed out of the socket. If this happens once, can increase the chance of a recurrence. In severe shoulder instability, the joint remains loose because the ligaments, the surrounding capsule and cartilage are stretched or torn. There may be recurring dislocations, along with chronic pain, swelling, popping or squeaking, and loss of sensation and function, even partial paralysis.

Shoulder reconstruction

Shoulder reconstruction surgery can treat shoulder instability and prevent dislocation. This surgery allows athletes to return to the game and increases productivity and overall quality of life for many patients..

Shoulder reconstruction surgery, also called Bankhart procedure, repairs ligaments to restore stability and safety of the loose shoulder joint. A torn labrum (a piece of fibrocartilage that holds the ball of the joint in place) reattaches to the shoulder socket and overstretched capsules and ligaments are repaired, tighten and reposition. This procedure can be performed arthroscopically through small incisions. Some cases require an open surgical procedure.

In some cases, shoulder instability is exacerbated by a fracture or bone loss. For these patients, a Laterjet operation may be recommended. This procedure involves a bone graft or transfer of a piece of bone from a section of the shoulder to the frontal socket.. Attached bone and muscles add stability to the joint, and the bone acts as a barrier to prevent the shoulder from slipping out of the socket. This method is very effective in treating and alleviating some types of shoulder instability..

About your shoulder

La articulación donde la parte superior del brazo se conecta a su cuerpo es una articulación esférica. The upper arm bone, called humerus, has a round end that fits into the curved frame on the outside of the shoulder blade.

Ligaments and tendons hold it together. Ligaments connect bones, while tendons connect muscles to bone. Una capa de tejido llamada cartílago mantiene los huesos separados para que no se froten entre sí.

The kneecap allows you to move your arm up and down, backwards and forwards, or in a circle.

Why would you need to replace it

You may need to do this if you have a condition that makes it painful and difficult to use your arm., como:

  • A serious shoulder injury such as a broken bone.
  • Severe arthritis
  • A torn rotator cuff

Your doctor will likely try to treat you first with medicine or physical therapy.. If they don't work, may recommend surgery.

Shoulder replacement surgery is less common than hip or knee replacements . But every year more than 50.000 shoulder replacements.

Shoulder anatomy

The joint that connects the upper arm to the body is called a ball joint which allows you to move the arm up and down, back and forth and in a circle. The upper arm bone is called the humerus and has a round end that sits on the curved structure on the outside of the shoulder blade..

Ligaments connect bones and tendons connect muscles to the bone that holds it together. A layer of tissue (cartilage) separate the bones so they don't rub against each other.

Why do I need shoulder reconstruction surgery?

Shoulder instability is a problem that occurs when the structures surrounding the shoulder joint, like ligaments, capsule and cartilage, they do not work to keep the ball tight inside its socket. If this happens, you may have a dislocated shoulder joint (where the joint has completely come out of the socket) the subluxation (partially out of lace). A dislocation occurs when the humerus (upper arm bone) is expelled from the glenoid (shoulder socket).

Shoulder instability commonly occurs due to a Bankart injury or tear. A Bankart tear is a specific injury to a part of the shoulder joint called the labrum.. The labrum is a ring of fibrous cartilage that stabilizes the shoulder joint and surrounds the glenoid. A Bankart tear can lead to regular dislocations, soft spot, shoulder pain or clicking and arthritis.

Shoulder instability can also be caused by an injury such as falling onto an outstretched hand or repetitive overhead sports such as netball or weight lifting..

If you have previously experienced a shoulder dislocation, may develop chronic instability. During the original dislocation, the ligaments that support the shoulder tear. If the ligaments heal too loose, your shoulder will be prone to repeat dislocations and instability.

Shoulder Reconstructive Surgery in bogota

Shoulder Reconstructive Surgery Bogota Medellin Colombia Cali Pereira Manizales

Chronic shoulder instability is often initially treated with nonsurgical treatments.. In most cases, is immobilized in a sling for 2 weeks and then a rehab plan is started.

If you suffer a dislocation between the ages of 15 a 25, may be prone to recurrent dislocations. If you have more than 40 years, you may suffer a rotator cuff tear with a dislocation rather than repetitive dislocations.

Strong rotator cuff muscles are the best protection against dislocation, shoulder subluxation and instability. A sufficient warm-up and certain exercises that strengthen the muscles around the shoulder are helpful..

If conservative treatments such as physical therapy, immobilization and medication fail to stabilize the shoulder, your doctor may recommend shoulder reconstruction surgery. Surgical options include both open and arthroscopic techniques.

Arthroscopic stabilization of the shoulder is a minimally invasive technique performed under general or regional anesthesia.. The surgeon will begin by doing 3 small incisions in the shoulder to insert the arthroscope (a small camera) which will send images to a monitor in the operating room, for the surgeon to examine. Liquid is passed (Saline solution) shoulder so the doctor can see the structures it contains. Later, damaged structures are repaired and tightened to help restore joint stability, usually by using small anchors in the shoulder socket and stitching the separated tissue to the bone.

Frequently Asked Questions about: Shoulder Reconstructive Surgery

Common Questions and Answers about Shoulder Reconstructive Surgery

Shoulder reconstruction surgery involves repairing the torn or stretched ligaments so they can better hold the shoulder joint in place.. If a treatment such as immobilization, medication, physical therapy and manipulation are not successful in treating torn or stretched ligaments, a shoulder reconstruction will be recommended.

During surgery, the torn area is sewn back into the shoulder socket with the help of special anchors and the capsules and overstretched ligaments are tightened.

Shoulder reconstruction can be performed through an endoscope with smaller incisions and small instruments to perform the repair. (keyhole surgery). However, some patients may need an open surgical procedure that involves a larger incision on the shoulder to perform the repair.

The surgeon will repair torn or stretched ligaments by reattaching them to the shoulder socket. Anchors help fix tissue to bone. The most common type of repair is called a SLAP repair., to mend the torn labrum, a piece of fibrocartilage that lines the edge of the shoulder socket.

Operation and recovery: your operation will generally take between one and two hours.
You will then stay in the recovery area until you are awake enough to return to the room.. This can take up to three hours.

Lines and drains: when you return to your living room, you may still need oxygen, have IV lines for fluids and pain relievers.

Diet: if you eat and drink normally immediately after the operation, may feel sick.
Eating and drinking small amounts slowly will help prevent this..
You should eat and drink normally the first day after the operation..

Pain: it is normal to feel some pain and discomfort after surgery. However, it is important that your pain is controlled so that you can cough, breathe deeply and do your exercises.
Tell someone about your pain so it can be treated and controlled. Ice packs can be used on the shoulder to help reduce swelling.

Infection control: I know will do everything possible to prevent infection. Hand hygiene is essential when recovering from this surgery. Wash your hands regularly.
Some doctors choose to prescribe antibiotics to help prevent infection.

Prevention of blood clots: to help prevent blood clots in the legs (thromboembolism), your doctor may ask you to wear a pair of white compression stockings and compression pumps after surgery. If your doctor has ordered stockings for you, you can take them off to shower and put them back on afterwards. You will need to wear the stockings for six weeks after the operation. Non-slip socks will also be provided.

Mobilization and exercise: he exercise is essential for proper rehabilitation and physical therapy
will start the day of the operation. Keeping your arm in a sling when in motion or placing a pillow under the operated arm, while resting in bed, will help prevent your arm from dislocating.

People with injuries to the shoulder ligaments or chronic instability due to recurrent dislocations are good candidates.. In general, rest and medication management is attempted first, but torn ligaments will only heal so far on their own.

Complications are rare (less than 2 percent of patients generally affected) after shoulder reconstruction surgery. Possible complications include infection, stiffness or restricted movement, nerve and vessel injury, procedure failure and side effects of general anesthesia.

As with any surgery, some results depend on the skill of the surgeon and surgical team. OrthoNebraska shoulder specialists perform many of these procedures each year. Other hospitals and general orthopedic surgeons will typically perform this procedure much less.

You may need a pre-surgical physical exam to make any necessary accommodations based on your medical history.. When i get to the hospital, talk to your surgeon and anesthesiologist. You are likely under general anesthesia (completely asleep) for this procedure.

In general, not a very painful procedure to recover, but they will probably prescribe some pain reliever. You can return to most of your normal activities when you stop taking the pain reliever, usually one to two weeks. You will be asked to wear a sling for four to six weeks, after which you will be asked to undergo physical therapy to restore range of motion and strength.

Full recovery takes four to six months, depending on the person and the specific techniques used during surgery.

People who have severe arthritis in the shoulder but whose rotator cuff tendons are intact (not torn) can benefit from total shoulder replacement surgery.

This procedure replaces both the ball (head of humerus) like cavity (glenoidea) of the shoulder joint. The new glenoid will be a plastic socket.

We often recommend a different type of total replacement for people who have severe shoulder arthritis along with significant rotator cuff tears or severe deformity with bone loss from the socket.. A reverse shoulder replacement also replaces both the ball and socket of the shoulder joint., but change their positions.

In this technique, our surgeons place a metal ball in the shoulder socket and a plastic socket in the upper end of the humerus. A reverse shoulder replacement allows the patient to use an upper arm muscle instead of the rotator cuff to lift and move the arm..

Shoulder reconstruction is a surgical procedure performed in patients with shoulder instability to improve stability., restore function and prevent recurrent dislocations of the shoulder joint.

Shoulder instability is a loose shoulder joint problem that occurs when the structures surrounding the shoulder joint, like ligaments, capsule and cartilage, overstretched or injured. When this happens, you may have a shoulder joint dislocation. A dislocation occurs when the head of the arm bone (humerus) is expelled from the shoulder socket (glenoides). Shoulder dislocation can be partial or complete. Partial dislocation occurs when the ball on the upper arm partially comes out of the socket. It is known as subluxation. Complete dislocation occurs when the ball comes completely out of the socket.

Shoulder instability most often occurs as a result of a Bankart injury or tear. The Bankart tear is a specific injury to a part of the shoulder joint called the labrum.. Labrum is a ring of fibrous cartilage that surrounds the glenoid and stabilizes the shoulder joint. Bankart tear causes recurrent dislocations, feeling of loosening, lack of strength, shoulder pain or clicking and arthritis. Shoulder instability can be caused by injury, a fall with an outstretched hand, repetitive overhead sports such as basketball, volleyball or weightlifting. Patients with shoulder instability may have severe pain, swelling, popping or squeaking, partial or complete dislocation, loss of sensation or partial paralysis and loss of function.

If conservative treatment, like immobilization, prescription drugs, physiotherapy, closed reduction or manipulation and occupational therapy, fails to relieve shoulder instability, your surgeon may recommend reconstructive surgery.

Shoulder reconstruction surgery involves repairing the torn or stretched ligaments so they can better hold the shoulder joint in place.. During surgery, the torn labrum is reattached to the shoulder socket with the help of special anchors and the capsules and overstretched ligaments are tightened.

  • Shoulder arthritis
  • Broken clavicle
  • Dislocated shoulder
  • Scapula fracture (scapula)
  • Frozen shoulder
  • Rotator cuff tears
  • Shoulder separated
  • Shoulder impingement (bursitis, tendinitis)
  • Shoulder joint replacement
  • Shoulder joint tear (desgarro del labrum glenoideo)
  • Thoracic outlet syndrome
  • Shoulder arthroscopy

Arthroscopy allows you to see the inside of the shoulder, making a more accurate diagnosis of the problems that occur in that joint. Besides, surgical treatment can be applied directly since most of the shoulder structures are accessible arthroscopically.

Shoulder arthroscopy is a minimally invasive surgical technique, but that allows us to access the two compartments that make up the shoulder joint: the glenohumeral joint and the subacromial joint. Being not very aggressive the postoperative is less painful for the patient and allows us an early home transfer. It is usually done under general anesthesia, but it can also be done with regional anesthesia and sedation.

The length of the procedure depends on the type of shoulder injury and the repair to be performed., but lasts between 30 and 90 minutes habitually. The patient usually spends the night in the hospital, to avoid postoperative pain. Post-procedure rehabilitation will depend on the intervention performed.

Arthroscopic access to the subacromial joint plays a fundamental role in the treatment of rotator cuff injuries (supra spinous) and allows us (due to new anchoring systems) repair widening breaks, so that the need for open repair of these types of injuries is increasingly rare.

It also allows you to subacromial decompressions, useful in patients with cuff injury and subacromial space narrowing; and also in patients without rotator cuff injury, but in which the narrowness of the subacromial space causes pain and limitation of mobility.

Accessing this space we can treat the pictures of glenohumeral instability, that is to say, of recurrent shoulder dislocation. Arthroscopic surgical techniques allow us to repair the labral lesions that occur during dislocations (Bankart and Hill-sachs injuries, and SLAP injury) and that can be difficult to access by non-arthroscopic techniques.

In these clinical pictures, it is increasingly rare to need open surgery, which is usually reserved for cases of failure of arthroscopic treatment.

Reconstructive shoulder surgery consists of offering those patients who suffer from pathologies in this joint, different treatments that can range from, open reduction plus fixation with fracture osteosynthesis materials.

Even joint replacements due to loss of the structural and functional anatomy of these joints. In this way, enabling optimal options for the shoulder to regain the degree of functionality that allows the patient to improve their quality of daily life..

In practice, reconstructive shoulder surgery, is an alternative to full replacement. The surgeons procedure, is based on the reconstruction of damaged bone and cartilage, at the ends of the joint bones.


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I broke my left rotator cuff while falling. I tried to put up with it for almost a year with medications, physical therapy and basically it didn't help . I was scheduled for surgery elsewhere. I did not like the atmosphere, so I looked for another opinion. I am happy to have done it !! all nursing staff, ambulatory surgical units, postoperative care and now the final results: I have no pain I have a full range of motion, I have strength and continue to develop it while following a very detailed therapy regimen. I can only recommend Dr.. Danilo Velandia and elite staff, professional, personal, warm and friendly.

Camila cardenas Orthopedics and Traumatology Patient

I am so impressed and grateful for the care that Dr.. Danilo, that every time I get a chance to give a positive review, I can not resist! The level of care he provides far exceeds that of any other doctor I have ever seen. I am so impressed. He patiently explained every detail of the treatment plan for my broken Knee to me and really took the time to listen and answer all the questions I had.. If I ever have to refer someone I know to an orthopedic surgeon, I will insist that they see Dr.. Danilo Velandia. There is no one else I would turn to if I needed one again. Thank you Dr. Danilo for the great care you have given me!

Raul Cespedes Orthopedics and Traumatology Patient

I have seen Dr.. Danilo Velandia a couple of times in Bogotá and I'll be back, it's been great so far. No pressure to rush to surgery, great advantage. Gives good information and options from the first day to the surgery process. All staff are friendly and helpful highly qualified, He has been the most proactive and helpful medical person I have dealt with and I am really very happy. Your diligence has made sure you get the help you need, and it even helped me avoid forgetting things. Thank you very much indeed! I am very happy with my visits with him. Highly recommended Dr. Danilo Velandia and his team of professionals!

Pedro Mutis Orthopedics and Traumatology Patient

My experience as a patient of Dr.. Daniel has been extremely positive. Performed surgery on my right shoulder, completely relieving my symptoms. He patiently listened to my concerns, answered my many questions and provided insightful information, but not too technical. The doctor. Danilo made himself available both before and after my surgery to address my pre-surgery nerves and my post-surgery expectations.. He was always professional, patient and attentive. I feel very lucky that when I could no longer suffer with the symptoms, my husband, who recommended me to Dr.. Danilo Velandia.

Maria lopez Orthopedics and Traumatology Patient

After playing competitive soccer for several years, I broke my anterior cruciate ligament and meniscus. I was very nervous about the long process of surgery and recovery really is a life changing process, I thought I would lose everything since sport is my life and my passion, but Dr.. Danilo Velandia was very helpful, informative and reassuring, he really knew how to handle the situation. My surgery went smoothly and my recovery went according to plan. The doctor. Danilo was present every step of the way and showed his medical competence, as well as his natural compassion, Thank you very much and very grateful, I have been able to continue with my day to day.

Andres Perea Orthopedics and Traumatology Patient

    Traumatologist Orthopedist