Shoulder Dislocation: Surgical Therapy

Depending on the exact nature of the shoulder lesion, surgical therapy must be used.

The following techniques are available depending on the exact nature of the lesion:

  • Arthroscopic/open rotator cuff suture for partial or small complete ruptures.
  • Open rotator cuff suture with/without acromioplasty (open or endoscopic straightening of the (pathologically) concave lower surface of the acromion) for major ruptures
  • Partial reconstruction or muscle valvuloplasty for rotator cuff rupture that cannot be anatomically reconstructed.
  • Arthroscopic removal of calcium

Further notes

  • Rotator cuff surgery is followed by four to six weeks of arm immobilization using an arm sling. In a small study with a relatively short follow-up period, it was shown six months later that if the arm sling was not used postoperatively (= sling-free rehab), the mobility was greater and the pain was slightly less.
  • In patients with small to moderate rotator cuff rupture, 10-year outcomes for patients undergoing primary surgery were significantly better than for patients undergoing physical therapy alone.
  • According to one study, scapula surgery (arthroscopic sub-acromial decompression) for subacromial shoulder pain (CSAW) has no clinically significant advantage over not undergoing treatment.Conclusion: only after months of unsuccessful conservative therapy, surgery should be discussed in such cases.