Shoulder preservation surgery is any surgical procedure that is aimed at preserving the structure and function of the native shoulder. It may be a good option when non-surgical treatments fail to relieve shoulder symptoms as it is less invasive than shoulder joint replacement surgery. In general, it is preferred for the younger patient with shoulder arthritis where shoulder joint replacement ideally wants to be delayed.
Shoulder Preservation Procedures
Most joint preservation surgeries can be performed using minimally invasive arthroscopic techniques. Some of the procedures that may be done include:
- Debridement with capsular release: This is used for the treatment of mild arthritis in the glenohumeral joint and usually involves the removal of loose pieces of cartilage. The inflamed joint lining, responsible for pain, is removed, and the capsule that is often contracted and causing stiffness of the shoulder, is released. This procedure is best suited for patients experiencing pain and mechanical catching in the shoulder along with associated stiffness in the presence of mild arthritis.
- Microfracture: This is a surgical procedure that relies on the various healing elements in the blood to generate new cartilage-like tissues in cartilage deficient areas. The procedure involves surgically making small holes in the bone so that the blood flows to the areas with cartilage loss through these holes. Biogel joint supplements may be applied to the area of microfracture to help keep the blood elements in the area of cartilage damage. This procedure is best suited when the areas of cartilage damage in the shoulder are limited and well defined and is not suitable for widespread cartilage loss on both sides of the joint.
Post-Operative Recovery after Shoulder Preservation Surgery
After joint preservation surgery, patients can expect to wear a sling for the first few days and follow a physical therapy program that will help restore shoulder range of motion and function. Physical therapy is important following surgery to help maximize the shoulder range of motion and strength. It may take about 6 to 12 months for the full benefit of the procedure to be realized.
Benefits of Shoulder Preservation Surgery
The benefits of shoulder preservation surgery include:
- Eliminates or reduces joint pain
- Improves or restores joint function
- Less invasive than total joint replacement surgery
- Delays or avoids joint replacement surgery
The aim of the procedure is to improve pain and function in the shoulder and “buy” the shoulder more years before joint replacement surgery is required.