Asheboro Orthopedics Archives

Chronic shoulder dislocation doesn’t have to be a life-long problem when Asheboro NC orthopedic surgeons can perform Bankart’s repair to your unstable shoulder joint. A joint that is too loose can slip and slide around in its socket, and can actually dislocate. The shoulder may slip back into proper position by itself, or the joint may need to be reduced, that is, manually returned to its natural state. Dislocation is a painful injury that requires immediate treatment to alleviate pain.


Shoulder physiology
Easily the most utilized and compliant joint in the human body, your shoulder has a very wide range of motion. The shoulder is made up of three bones: scapula, or shoulder blade; clavicle, or collar bone; and humerus, or arm bone. These bones are joined together by soft tissues: muscles, tendons, and ligaments. The shoulder joint is enclosed inside a watertight capsule which contains lubricating fluid for the entire joint. The joint capsule walls allow space and flexibility for the shoulder’s unrestricted range of motion.The main joint consists of the ball-shaped head of the humerus, and a cup-shaped hollow on the shoulder blade called the glenoid. The rim of this cup-shaped hollow is called the labrum, and this soft tissue plays a big part in chronic shoulder dislocation and Bankart’s repair.


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What causes chronic shoulder dislocation?
If injury causes an initial shoulder dislocation, the joint may remain unstable afterward if ligaments that should keep the shoulder in its socket were torn or stretched during the injury. Alternatively, you may develop chronic shoulder dislocation by repeated stretching of the joint capsule during overhead sports activity such as volleyball, basketball, or swimming, or during other repetitive overhead movement at work or at home. Moving inside its loosened environment, your shoulder can easily slip and slide, wearing or tearing the soft tissue rim of the glenoid hollow. A labral tear can in turn cause your shoulder to become even less stable, and may become so damaged a flap of the labrum gets caught between the humerus head and glenoid hollow, painfully catching when you move your shoulder. A chronically dislocated shoulder actually feels unstable, and many sufferers simply stop attempting certain arm motions that make them fear a dislocation will occur.


Can chronic shoulder dislocation be treated non-surgically?
For your orthopedic surgeons at Randolph Orthopedics and Sports Medicine in Asheboro NC, alleviating your pain and lessening inflammation will be a first goal. Other non-surgical treatments may include rest, anti-inflammatories, pain killers, cortisone injections, ice or heat treatments and physical therapy. Many chronic shoulder dislocations are treated successfully in this way.


What is Bankart’s repair surgery?

If your chronic shoulder dislocation symptoms don’t go away, your orthopedic surgeon may need to tighten loose ligaments and repair the labrum. The Bankart repair, as it is sometimes called, is generally performed arthroscopically, that is, using a fiber-optic camera and manipulating instruments through several small incisions. Your orthopedic surgeon will make several small incisions around the shoulder to allow for insertion of the camera and surgical instruments. This approach can decrease tissue damage near the repaired joint, and shorten healing and recovery time. Torn or otherwise damaged soft tissue is removed, bone spurs are removed, and rough edges are smoothed.  Next your surgeon will stabilize the shoulder joint by shortening and reattaching the loosened ligaments.In Bankart’s repair, special devices called suture anchors are used to reattach ligaments to the bone. Small enough to be inserted arthroscopically, the suture anchors are made of metal or of a plastic that dissolves over time. Your orthopedic surgeon drills the anchor into the bone, and attaches the ligaments securely to the anchor. Over time, metal becomes merged with bone and the sutures dissolve, preparing your shoulder for return to normal function.


What is recovery after Bankart’s repair like?
You may be able to go home the same day after arthroscopic Bankart’s repair. Aftercare will include rest, use of a sling to immobilize the joint as it heals, and a carefully designed regimen of physical therapy, beginning with simple motion exercises. Your orthopedic surgeon will tell you when you can return to normal day-to-day activity. Total recovery may take a few months.Chronic shoulder dislocation doesn’t have to limit your activities. Contact the orthopedic surgeons at Randolph Orthopedics and Sports Medicine in Asheboro NC for an examination to see if Bankart’s repair can help you regain full use of your shoulder.


Rating: 8 out of 10 (from 12 votes)

By Ranbir Singh, MD

Arthritis is defined as inflammation of the joint and refers to more than 100 different diseases that can affect joints. However, today we will focus on the two most common types of arthritis, rheumatoid arthritis and osteoarthritis.

Rheumatoid arthritis is usually diagnosed at much younger ages than osteoarthritis. It is not as common, but it can affect multiple joints at one time. It causes excess synovial fluid to build up in the joint. The excess fluid builds pressure inside the joint leading to cartilage erosion. Rheumatoid arthritis causes painful, swollen joints and limited joint motion.

Osteoarthritis is the most common form of arthritis. It is a “wear and tear” condition that affects joint cartilage. Osteoarthritis develops over a lifetime of overuse, injury, repetitive movement, or developmental disorders of the bone. In osteoarthritis, the healthy cartilage just wears away and the joint space becomes narrowed. When bone-on-bone contact occurs, abnormal bone formations, called spurs, develop and can lead to joint deformities. Fortunately, osteoarthritis is a condition that can usually be managed with either conservative or surgical treatments.

For patients with arthritis, a proper diagnosis is crucial to get the best treatment options. It is important to be seen by an orthopedic surgeon trained in joint replacement surgery. But seeing an orthopedic surgeon does not mean that you are going to have joint replacement surgery.  It simply means you are seeing a specialist in the care and treatment of joint, muscle and other skeletal disorders.

Conservative Treatments

A well-balanced diet coupled with regular doctor prescribed low-impact exercise can help reduce excess body weight, decrease pressure on the joints and increase joint space.

Medications such as pain-relievers, anti-inflammatories and steroid injections can help relieve both joint swelling and pain. Glucosamine, a building block of cartilage, and chondroitin sulfate, also found in cartilage, are two common supplements that have been shown to help relive the symptoms of early osteoarthritis. You should speak with your doctor before taking any vitamins or nutritional supplements.

Physical Therapy may be used to help strengthen the joint and promote less painful functions. Weak or tight muscles provide little support and can make it difficult to move the joint. Physical therapy can help loosen and strengthen muscles, possibly providing relief from joint pain.

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Is there a cure for Osteoarthritis?

There is no known cure, however, patients have many treatment options available to restore motion and reduce pain. For end-stage osteoarthritis, joint replacement has proven effective in accomplishing these goals.

Does Joint Replacement Work?

After joint replacement surgery, many patients experience reduced pain, increased mobility and improved quality of life. The performance and life span of an implant depends upon many factors, including the patient’s pre-surgical physical condition, anatomy, weight, activity and willingness to follow surgeon instructions before and after surgery.

What is Partial Knee Replacement Surgery?

Unlike total knee replacement involving removal of all the knee joint surfaces, the Oxford Partial Knee Replacement replaces only one side of the knee joint, removing 75 percent less bone and cartilage. Knee osteoarthritis usually occurs first in the medial, inside compartment of the knee, as this side of the knee bears most of the weight. In knees that are otherwise healthy, a partial approach allows the outer compartment and all ligaments to remain intact. By retaining all of the undamaged parts, the joint may function more naturally with faster recovery after surgery. However, in situations when all three compartments of the knee are damaged, then the patient will need a total knee replacement.

The Oxford Partial Knee is the only FDA-approved free-floating meniscal partial knee system available in the United States and has been utilized throughout Europe for more than two decades. Often recognized as the most widely used and clinically proven partial knee system in the world, the Oxford Partial Knee System has demonstrated excellent clinical results. Surgeons in the US who wish to use the Oxford Partial Knee System are required by the FDA to attend an advanced instruction course on the device and there are only a few in the state of North Carolina who have done so including myself and I am the only one performing this procedure at Randolph Hospital.

In a healthy knee, the meniscal cartilage serves as a shock absorber between the ends of bones. In a partial knee replacement the implant has an artificial meniscal designed to glide freely throughout the knee’s range of motion to more closely replicate normal movement. It is designed to balance the soft tissues and to accurately replicate normal knee motion. It may also allow for a more rapid recovery due to the use of minimally invasive instruments – meaning the procedure is performed through a very small incision.

Returning to Daily Activities

Patients should be able to return to low impact activities like golfing, swimming, bicycling between one and two months after surgery. To help evaluate your progress after surgery, you will have several follow-up visits to see your surgeon. During the first year, you will follow up with a surgeon about every three months so your progress and the condition of your implant can be monitored.


Rating: 8 out of 10 (from 12 votes)

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