The glenohumeral joint, one of four joints within the shoulder girdle, is formed by the juncture of the head of the humerus (upper arm bone) into the glenoid socket of the scapula (shoulder blade). This joint is a ball-and-socket design that enables a wide range of motion at the cost of a higher risk of injury to the soft-tissue restraints (ligaments, tendons, and labrum). A forward (anterior) shoulder dislocation can result in a tear in the anterior labrum of the shoulder, which can itself increase the risk of a recurrent dislocation.

The shoulder joint provides a wide range of movement to the upper extremity. Multiple factors contribute to the stability of the shoulder joint including the shape of the bones that forms the joint, in addition to the labrum, a cartilaginous rim that surrounds the joint. The Latarjet procedure is indicated for anterior shoulder instability that is recurrent and associated with a bony defect that changes the shape of the bony stabilizers of the joint. This procedure involves relocating a piece of bone with an attached tendon to the shoulder joint adding to joint stability by multiple mechanisms. This surgery is specially considered when a surgical repair of the labrum alone is not enough for restoring the stability of the shoulder joint.

Reverse total shoulder replacement, is an advanced surgical technique specifically designed for rotator cuff tear arthropathy, a condition where the patient suffers from both shoulder arthritis and a rotator cuff tear. The shoulder joint is a ball and socket joint formed by the union of the head of the upper arm bone (humerus) and the shoulder socket (glenoid). The rotator cuff is a group of four tendons that join the head of the humerus to the deeper shoulder muscles to provide stability and mobility to the shoulder joint.

When the rotator cuff is torn, it can cause wear and tear to the shoulder joint and lead to shoulder arthritis. Conventional surgical methods such as total shoulder joint replacement have been shown to be significantly ineffective in the treatment of Rotator cuff arthropathy.

Conventional shoulder replacement surgery involves replacing the ball of the arm bone (humerus) with a metal ball and the socket (glenoid cavity) of the shoulder blade (scapula) with a plastic socket. If this surgery is used to treat rotator cuff arthropathy, it may result in loosening of the implants due to the torn rotator cuff. Therefore a specifically designed surgery was developed called reverse total shoulder replacement to be employed in such cases. In reverse total shoulder replacement, the placement of the artificial components is essentially reversed. In other words, the humeral ball is placed in the glenoid cavity of the shoulder blade (scapula) and the plastic socket is placed on top of the arm bone. This design makes efficient use of the deltoid muscle, the large shoulder muscle, in order to compensate for the torn rotator cuff.

Rotator cuff is the group of tendons in the shoulder joint providing support and enabling wider range of motion. Major injury to these tendons may result in tear of these tendons and the condition is called as rotator cuff tear. It is one of the most common causes of shoulder pain in middle aged adults and older individuals. It may occur with repeated use of arm for overhead activities, while playing sports or during motor accidents. Rotator cuff tear causes severe pain, weakness of the arm, and crackling sensation on moving shoulder in certain positions. There may be stiffness, swelling, loss of movements, and tenderness in the front of the shoulder.

Rotator cuff tear is best viewed on MRI. Symptomatic relief may be obtained with conservative treatments – rest, shoulder sling, pain medications, steroidal injections and certain exercises. However, in order to fix the tendon back to the shoulder bone, surgery is required. Rotator cuff repair is performed by Dr. Yehia Bedeir through tiny incisions, 1 cm each, around the shoulder using arthroscopy.

During shoulder arthroscopy, all rotator cuff tendons are visualized in detail and the cuff tear is repaired using suture anchors. These anchors help in attaching the tendons to the shoulder bone. Following the surgery, you may wear a sling for about 6 weeks until the tendon heals back to the bone.

The benefits of arthroscopy compared to the alternative, open shoulder surgery, include:

• Smaller incisions
• Minimal soft tissue trauma
• Less pain
• Faster healing time
• Lower infection rate
• Less scarring
• Earlier mobilization
• Usually performed as outpatient day surgery

Shoulder arthroscopy is a widely used minimally invasive procedure used for inspection, diagnosis and treatment of certain injuries in and around the shoulder joint. This procedure involves an arthroscope (tiny camera) as well as specially designed, thin surgical instruments to inspect and repair the complex soft tissue structures of the shoulder following an injury or degenerative condition. Dr. Yehia Bedeir uses arthroscopic surgery to treat a variety of shoulder conditions and return patients to an active lifestyle. As opposed to open shoulder surgery, arthroscopic surgery features much less postoperative pain and faster recovery time. The majority of arthroscopic shoulder surgery cases performed by Dr. Bedeir are completed under regional or general anesthesia on an outpatient basis.