Shoulder Orthopedic Care at Maimonides

The shoulder is a ball-and-socket joint that allows for a wide range of motion in the arm. This highly flexible joint is supported by a group of muscles and tendons known as the rotator cuff. The rotator cuff helps to lift the arm and keep the ball of the joint in place.

Orthopedic conditions that can affect the shoulder include rotator cuff tears, shoulder impingement, and frozen shoulder. These conditions can cause pain and limited mobility in the arm. Orthopedic surgery may be necessary to repair damaged tissue or to realign the bones in the joint. The Bone and Joint Center at Maimonides provides world-class orthopedic care for patients with shoulder conditions. Our team of experienced surgeons can provide the latest treatments and procedures to help you get back to your normal activities.

  • One of Healthgrades America’s 100 Best Hospitals for orthopedic surgery two years in a row (2022-2023)
  • Recipient of Healthgrades Orthopedic Surgery Excellence Awards for two years in a row (2022-2023)
  • Named among the top 5% in the nation for overall orthopedic services for two years in a row (2022-2023)

To schedule an appointment, call 718.283.7400 today.

The Anatomy of the Shoulder

Bones

There are three bones that make up the shoulder joint: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone).

The ball of the shoulder joint is formed by the head of the humerus. This ball fits into a shallow socket on the scapula, known as the glenoid. The glenoid is held in place by a ring of connective tissue called the labrum.

The scapula is a triangular-shaped bone that sits at the back of the shoulder. It is attached to the humerus at the glenoid and to the clavicle at the acromion.

Finally, the clavicle is a long, thin bone that runs from the base of the neck to the acromion. It connects the scapula to the sternum (breastbone).

Soft Tissues

In addition to the bones, there are a number of other structures that make up the shoulder joint. These include the ligaments, tendons, muscles, and bursae.

Ligaments are bands of connective tissue that attach bone to bone. There are four main ligaments in the shoulder: the glenoid labrum, the coracohumeral ligament, the transverse humeral ligament, and the acromioclavicular (AC) ligament.

Tendons are also made of connective tissue. They attach muscles to bone. In the shoulder, there are three main tendons: the biceps tendon, the triceps tendon, and the rotator cuff tendon.

The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) and their corresponding tendons that surround the shoulder joint. These muscles help to lift the arm and keep the ball of the joint in place.

Finally, bursae are small, fluid-filled sacs that act as cushions between bones and muscles. There are several bursae in the shoulder joint, including the subacromial bursa, the subscapularis bursa, and the subdeltoid bursa.

Nerves and Blood Vessels

The shoulder joint is supplied by a number of nerves and blood vessels. The primary nerve that innervates the shoulder is the suprascapular nerve. This nerve runs from the neck to the shoulder and supplies sensation to the skin on the upper arm.

The blood supply to the shoulder comes from the axillary artery. This artery runs from the neck to the shoulder and supplies oxygen-rich blood to the muscles and tissues in the area.

Common Orthopedic Shoulder Conditions

There are a number of orthopedic conditions that can affect the shoulder. These include:

  • Shoulder arthritis
  • Shoulder fracture
  • Rotator cuff tear
  • Bicep tendonitis of the shoulder
  • Labral Tears
  • Shoulder arthritis

Damaged cartilage can lead to shoulder arthritis. Arthritis is a degenerative disease that causes the breakdown of cartilage in the joints. This can lead to pain, swelling, and stiffness in the affected joint.

There are a number of different types of arthritis that can affect the shoulder. The most common type is osteoarthritis, which is caused by the wear and tear of the cartilage. Other types of arthritis include rheumatoid arthritis, psoriatic arthritis, rotator cuff arthritis and septic arthritis.

Symptoms include:

  • Shoulder pain
  • Stiffness in the shoulder
  • Decreased range of motion in the shoulder

Treatment typically involves a combination of medication and physical therapy, with surgery as a last resort. Joint replacement is a common surgical procedure for shoulder arthritis.

Shoulder Fracture

A shoulder fracture is a break in one of the bones that make up the shoulder joint. The most common type of shoulder fracture is a broken collarbone (clavicle). This can occur due to a fall or direct blow to the area.

Symptoms include:

  • Shoulder pain
  • Swelling and bruising in the shoulder
  • Deformity in the shoulder
  • Decreased range of motion in the shoulder

Treatment typically involves immobilization of the shoulder in a sling or splint. Surgery may also be necessary to realign the bones.

Rotator Cuff Tear

A rotator cuff tear is a tear in one of the tendons that attach the muscles of the rotator cuff to the shoulder bone. This can be caused by repetitive stress or a direct injury to the area.

Symptoms include:

  • Shoulder pain
  • Weakness in the shoulder
  • Decreased range of motion in the shoulder
  • Swelling and bruising in the shoulder

Treatment typically involves a combination of medication, physical therapy, and rest. Surgery may also be necessary to repair the tendon.

Bicep Tendonitis of the Shoulder

Bicep tendonitis is an inflammation of the biceps tendon. This tendon attaches the biceps muscle to the shoulder. Bicep tendonitis is often caused by repetitive stress or overuse of the arm.

Symptoms include:

  • Pain
  • Swelling and bruising
  • Weakness in the arm
  • Decreased range of motion

Treatment typically involves rest, ice, and physical therapy. When conservative measures fail, surgery may be necessary to remove the damaged tendon. Your orthopedic surgeon will make a small incision in the shoulder and insert a camera to visualize the tendon. The damaged tendon is then removed and the healthy tendon is reattached to the bone.

Labral Tear

A labral tear is a tear of the lining of the socket that may cause a patient’s shoulders to dislocate or pop out of the socket. Initial treatment involves sling use, rest as well as physical therapy. In cases of repeated instability, your surgeon can use small incisions, insert a camera, and repair the torn labrum back to the bone to restore shoulder stability.

Orthopedic Procedures for the Shoulder

To identify and treat shoulder conditions, your orthopedic surgeon may recommend a number of different procedures. These include:

Shoulder Arthroscopy

Arthroscopy is a minimally invasive surgical procedure that is used to visualize, diagnose, and treat problems inside the shoulder joint. A small incision is made in the skin, and a camera is inserted into the joint. This allows your surgeon to see the inside of the joint without having to make a large incision.

After diagnosis, your surgeon can treat the problem by making small incisions and inserting surgical instruments into the joint.

Total Shoulder Replacement

A shoulder replacement is a surgical procedure that is used to treat severe shoulder arthritis. The damaged bone and cartilage are removed and replaced with artificial components. This surgery can provide relief from pain and restore function to the shoulder.

Your orthopedic surgeon will make an incision in the front of your shoulder and detach the muscles around the joint. The damaged bone and cartilage are then removed and replaced with artificial components. The muscles are then reattached to the new joint. Shoulder replacements can now be done as same-day discharge surgeries.

Rotator Cuff Repair

A rotator cuff repair is a surgical procedure that is used to treat a rotator cuff tear. The torn tendon is repaired and reattached to the bone. If you’re experiencing pain and weakness in your shoulder, you may be a candidate for this procedure.

Your orthopedic surgeon will make small 1 cm incisions around the shoulder and use a camera to identify the torn tendons. The torn tendons are then repaired using specialized arthroscopic (minimally invasive) tools and reattached to the bone.

Biceps tendon repair

A biceps tendon repair is a surgical procedure that is used to treat a biceps tendon tear. This tendon can rupture as a result of a fall, direct blow, or overuse. Symptoms of a ruptured biceps tendon include sudden pain and a popping sensation in the arm.

During the procedure, your orthopedic surgeon will make an incision in the front of your shoulder and detach the muscles around the joint. The torn tendon is then repaired and reattached to the bone.

Labral Repair

A labral repair is done by making three small 1 cm incisions around the shoulder. A camera is then used to identify the labral tear, and specialized arthroscopic (minimally invasive) equipment is used to reattach the labrum to the bone.

To schedule an appointment, call 718.283.7400 today.

 

Maimonides Bone & Joint Center
6010 Bay Parkway
7th & 8th Floors
Brooklyn, NY 11204
Monday-Friday, 8 am – 6 pm

Telephone for all locations: 718-283-7400
Maimonides Bone & Joint Center
Physical Therapy and Rehabilitation
6010 Bay Parkway
1st Floor
Brooklyn, NY 11204

Telephone for all locations: 718-283-8962 
Maimonides Bone & Joint Center – Brooklyn Heights
26 Court Street
Brooklyn, NY 11242
Monday-Friday, 8 am – 6 pm

Telephone: 718-283-7400
Maimonides Bone & Joint Center – Kings Highway
1715 East 13th Street
4th Floor
Brooklyn, NY 11219
Monday-Friday, 8 am – 6 pm

Telephone: 718-258-2588
Maimonides Bone & Joint Center
Physical Therapy and Rehabilitation
1715 East 13th Street
Suite 402
Brooklyn, NY 11219

Telephone: 718-258-1238
Maimonides Medical Center Ambulatory Health Services Network (AHSN)
Orthopedic Services
948 48th Street
Brooklyn, NY 11219

Telephone: 718-283-7431

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