This type of calcification does not result from trauma, not even from an overuse injury. It is thought that it occurs in an area of reduced blood flow where some cells are wrongly encouraged to develop calcium.

The cementless Copeland replacement shoulder is a resurfacing device with minimal bone resection, which is an ideal solution for a minimally damaged shoulder.

Shoulder arthroscopy is keyhole surgery, in which the surgeon inserts a scoop (or a camera) through a tiny incision to examine the shoulder joint. Keyhole surgery on the shoulder can be a diagnostic or therapeutic procedure. The surgeon makes tiny incisions to insert the lens and other instruments. The operation is less invasive, scars are much smaller and recovery is much speedier.

The shoulder is a complicated joint that has the greatest mobility. In the shoulder joint the following bones meet: the upper arm (humerus), the shoulder blade (scapula) and the collarbone (clavicle). The actual joint itself is formed by the head of the upper arm (humeral head) and the socket (glenoid), which  is part of the shoulder blade. The highest point of the shoulder is formed by a prominence of the shoulder blade, which is called the acromion.

Description of this shoulder injury

When lifting the arm sidewards or forwards, the tendons of the rotator cuff need to slide underneath the acromion (=a bony prominence of the shoulder blade). There is usually plenty of space to do so, but there is always some kind of friction between the tendons, the bursa and the acromion. This friction is also known as ‘impingement’.

Fractures of the shoulder joint are quite common. They account for approximately 4 to 5 % of all fractures. Especially later on in life, people run the risk of sustaining such fractures, because their bones have become weaker from osteoporosis. A fracture usually occurs after a fall on the shoulder or on an extended arm. The seriousness of a fracture depends on the force or the impact that caused the fracture, on the one hand, and on the strength of the bone, on the other. If the impact is extreme, as in a road accident, the bone can be shattered and the fragments can be displaced.

Approximately 80 to 85 % of all shoulder fractures are minimally or non-displaced fractures. The other fractures are classified according to a particular classification system. There are several systems, but the one used most is Dr. Charles Neer’s classification system.

Acromioclavicular Injuries

The acromioclavicular joint (the shoulder joint) is the connection between the collarbone and the shoulder blade. This narrow little joint can cause severe shoulder pain due to wear-and-tear (arthrosis) or after trauma (dislocation).

AC-arthrosis

Wear-and-tear of this shoulder joint is part of the normal ageing process. It often goes hand in hand with the impingement of the tendon. Pain especially occurs while lifting, moving the shoulder backward and sleeping on the shoulder at night.

Treating a painful shoulder joint

• At the initial stage we recommend avoiding heavy lifting. An injection into the joint can sometimes bring improvement for a long time. If so, an injection can be repeated 1 or 2 times in the long run.
• In an advanced state of damage surgery will be necessary. We will widen the joint by removing part of the tip of the collarbone. This is done through keyhole surgery, under short, general anaesthesia, with a possible hospital stay of one night. After surgery we rest the arm for a couple of days to weeks, depending on the pain symptoms. We advise you against heavy lifting for the first six weeks. After a short while a little pseudo-joint will develop at the same place.

Shoulder instability is the impossibility to keep the humeral head centred in the glenoid (shoulder socket). The shoulder joint is the most mobile joint in our body. To gain this mobility a special mechanism needs to be developed to keep the joint stable as well. It is a delicate balance. The stabilizing elements of the shoulders are both static and dynamic

Dynamic elements: The rotator cuff muscles are of particular importance here. It is the synergy between the anterior and posterior muscle groups that will make sure that the humeral head will always stay perfectly centred in relation to the glenoid.

How do those injuries come into being ?

The shoulder tendon plate is formed by the attachment of a number of muscles to the head of the humerus. These muscles help to move the upper arm in different ways (raising your arm, turning it inward or outward) and they stabilize the head of the humerus in the shoulder socket.

The right arm:

The rotator cuff is formed by:

•  The subscapularis muscle (in front)
• The supraspinatus muscle (at the top)
• The infraspinatus and teres minor muscle (at the back)

What is a SLAP tear ?

The long biceps tendon is attached to the top of the glenoid and runs into the labrum, a cuff of cartilage that has a stabilizing function round the glenoid. An injury to this attachment, combined with an injury to the adjacent superior labrum toward the front and/or the back, is called a SLAP tear (Superior Labrum Anterior to Posterior). Depending on the pathology these tears can traditionally be divided into 5 types, from SLAP I to SLAP V.