Hottest Techniques in Shoulder SurgeryThe ball and socket joint of the shoulder normally moves with ease in all directions. However, the joint can become unstable, moving too far or slipping when it shouldn't. When the shoulder is able to shift too far in more than one direction, it is called multidirectional shoulder instability. When this happens, pain, "popping," and dislocation can occur.
Treatment for shoulder instability is with medications (antiinflammatories), physical therapy to strengthen the muscles, and changes in activities. Surgery may be needed if symptoms keep on after three to six months of regular therapy. The purpose of the surgery is to tighten up the shoulder joint.
This can be done in several different ways. The joint may be opened up so stretched tissue can be pulled tight and held in place. The same result can occur without cutting the joint open. The doctor uses a tool called an arthroscope, a slender instrument inserted into the joint with a TV camera on the end. This allows the surgeon to see inside and tighten the shoulder joint without a large scar and without too much tissue damage from surgery.
A newer method uses arthroscopy and laser to the treat the joint. Laser is a form of light energy that creates heat. This heat can be applied to the joint to shrink and stiffen the tissue. Researchers are reporting the results of laser heat for multidirectional shoulder instability. The amount of heat used and the length of time needed for healing with this treatment are still unknown. More studies are being done to compare this method with the standard surgery for shoulder instability.
Paul J. Favorito, MD, et al. Arthroscopic Laser-Assisted Capsular Shift in the Treatment of Patients With Multidirectional Shoulder Instability. In The American Journal of Sports Medicine. May/June 2002. Vol. 30. No. 3. Pp. 322-328.
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