Shoulder replacement is a surgical procedure in which all or part of the glenohumeral joint is replaced by a prosthetic implant. Human Anatomy. Return to Sport After Arthroscopic Rotator Cuff Repair: Is There a Difference Between the Recreational and the Competitive Athlete? Many researchers have tried to identify safe regions, but the results vary among published studies. Hip-joint 182 Knee-joint 184 Articulations between the Tibia and Fibula 188 Ankle-joint . The deltopectoral approach is the workhouse approach to the shoulder for use in shoulder stabilisation, arthroplasty and fracture fixation. I traveled from PA. Clinical Results Following Non-operative Management for Grade III Acromioclavicular Joint Injuries: Does Eventual Surgery Affect Overall Outcomes? The Steadman Philippon Research Institute It is our goal to provide the highest level of care and service to our patients. I can now sleep, dress, drive, along with all the daily activities I was previously unable to do. It stabilizes the shoulder and holds the head of the humerus in the glenoid, a … The next layer of the shoulder is made up of the ligaments (soft tissue structures that connect bone to bone) of the joints. Vail, CO 81657, Tel: 970-479-5871 Articular Anatomy. In this issue we focus on glenohumeral and acromioclavicular joints. . Four major shoulder joints help to achieve a complex range of motion: the glenohumeral joint, the acromioclavicular joint, the scapulothoracic joint, and the sternoclavicular joint. To reduce the disproportion in surfaces, the glenoid fossa is deepened by a fibrocart… The rotator cuff also helps stabilise the shoulder joint by holding the humeral head in the socket. Dr. Millett is a world class surgeon located in a world class facility in beautiful Vail, CO. What more can you say? Management of a Patient With an Isolated Greater Tuberosity Fracture and Rotator Cuff Tear, Percutaneous Treatment of Proximal Humerus Fractures, Achilles tendon allograft-augmented latissimus dorsi tendon transfer for the treatment of massive irreparable posterosuperior rotator cuff tears, Anatomy and Dimensions of Rotator Cuff Insertions, Anterior Capsular Reconstruction for Irreparable Subscapularis Tears, Arthroscopic Double-Row Transosseous Equivalent Rotator Cuff Repair with a Knotless Self-Reinforcing Technique, Arthroscopic Knotless, Double-Row, Extended Linked Repair for Massive Rotator Cuff Tears, Arthroscopic Pancapsular Shift With Labral Repair for Multidirectional Instability of the Shoulder, Arthroscopic Rotator Cuff Repair Instruments and Equipment: Setting Yourself Up for Success, Arthroscopic Rotator Cuff Repair: Rationale, Technique, and Results of Knotless Self-Reinforcing Double-Row Rotator Cuff Repair, Arthroscopic rotator cuff repair: Scientific rationale, surgical technique, and early clinical and functional results of a knotless self-reinforcing double-row rotator cuff repair system, Arthroscopic Single-Row Versus Double-Row Repair for Full-Thickness Posterosuperior Rotator Cuff Tears, Arthroscopic Single-Row Versus Double- Row Suture Anchor Rotator Cuff Repair, Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears, Arthroscopic Superior Capsular Reconstruction for Treatment of Massive Irreparable Rotator Cuff Tears: An Update of the Technique for 2020, Arthroscopically Assisted Latissimus Dorsi Transfer for Irreparable Rotator Cuff Tears, Association Between Acromial Index and Outcomes Following Arthroscopic Repair of Full-Thickness Rotator Cuff Tears, Biologics to Improve Healing in Large and Massive Rotator Cuff Tears: A Critical Review, Biomechanical Analysis of Two Tendon Posterosuperior Rotator Cuff Tear Repairs: Extended Linked Repairs and Augmented Repairs, Calcifying tendinitis of the rotator cuff with cortical bone erosion, Clinical and Imaging Outcomes After Arthroscopic Superior Capsule Reconstruction With Human Dermal Allograft for Irreparable Posterosuperior Rotator Cuff Tears: A Minimum 2-Year Follow-Up, Clinical and Structural Outcomes After Arthroscopic Repair of Full-Thickness Rotator Cuff Tears With and Without Platelet-Rich Product Supplementation: A Meta-analysis and Meta-regression, Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: a systematic review and meta-analysis of level I randomized clinical trials, Coracoplasty: Indications, Techniques, and Outcomes, Cost-Effectiveness of Arthroscopic Rotator Cuff Repair Versus Reverse Total Shoulder Arthroplasty for the Treatment of Massive Rotator Cuff Tears in Patients With Pseudoparalysis and Nonarthritic Shoulders, Double-row Rotator Cuff Repair Strategies. Bones and joints form the deepest layer of the shoulder. 181 Articulations of the Lower Extremity. Shoulder replacement surgery is an option for treatment of severe arthritis of the shoulder joint. It is the tendon that enables you to lift your arm out to the side (an important movement for most daily tasks). All the nerves travelling down the arm pass through the axilla (armpit) just below the shoulder joint. After several prior diagnoses and surgeries (shoulder and spinal) by other surgeons over the years, Dr. Millett correctly identified my rather unusual shoulder issue as Suprascapular Neuropathy (SSN). HONcode standard for trustworthy health information. Tendons are extensions of muscles and attach muscles to bone. Arthroscopically Assisted Anatomic Coracoclavicular Ligament Reconstruction Technique Using Coracoclavicular Fixation and Soft-Tissue Grafts, Two-Year Outcomes After Primary Anatomic Coracoclavicular Ligament Reconstruction, Acromioclavicular and coracoclavicular PDS augmentation for complete AC joint dislocation showed insufficient properties in a cadaver model, The effects of arm elevation on the 3-dimensional acromiohumeral distance: a biplane fluoroscopy study with normative data, Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique, Acromioclavicular Joint Injuries: Anatomy, Diagnosis and Treatment, Acromioclavicular Joint Instability—Reconstruction Indications and Techniques, Subcoracoid Impingement: Factors Associated with the Size and Location of the Coracohumeral Interval, Anterior Shoulder Instability in the Professional Athlete: Return to Competition, Time to Return, and Career Length, Impact of Age and Subscapularis Tendon Reparability on Return to Recreational Sports Activities and 2-Year Outcomes After Reverse Total Shoulder Arthroplasty, Operative treatment of torsional humeral shaft fractures in throwers leads to an earlier return to sport: a survey of expert shoulder and elbow surgeons, Outcomes After Arthroscopic Pancapsular Capsulorrhaphy With Suture Anchors for the Treatment of Multidirectional Glenohumeral Instability in Athletes, Posterior bony Bankart bridge technique results in reliable clinical 2-year outcomes and high return to sports rate for the treatment of posterior bony Bankart lesions, Return to Recreational Sporting Activities Following Total Shoulder Arthroplasty, Shoulder Injuries in the Throwing Athlete, Shoulder Injuries in the Throwing Athlete 2, Cartilage Microfrature Joint Preservation Surgery, The Use of Biological Approaches in the Treatment of Shoulder Pathology, Treatment of Osteoarthritis of the Knee with Microfracture and Rehabilitation, Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis, Arthroscopic Management of Glenohumeral Arthrosis, Chondral and Osteochondral Lesions of the Humerous: Diagnosis and Management, Outcomes of Full-Thickness Articular Cartilage Injuries of the Shoulder Treated With Microfracture, Intramedullary Fixation of Midshaft Clavicle Fractures, Concomitant glenohumeral pathologies associated with acute and chronic grade III and grade V acromioclavicular joint injuries, Surgical Anatomy of the Sternoclavicular Joint, Clinical outcomes after autograft reconstruction for sternoclavicular joint instability, Biomechanical Comparison of Surgical Techniques for Resection Arthroplasty of the Sternoclavicular Joint, Arthroscopic Sternoclavicular Joint Resection Arthroplasty: A Technical Note and Illustrated Case Report, Instability and Degenerative Arthritis of the Sternoclavicular Joint, Midshaft Clavicle Fracture Open Reduction and Internal Fixation, Biomechanical Consequences of Coracoclavicular Reconstruction Techniques on Clavicle Strength, Stability of mid-shaft clavicle fractures after plate fixation versus intramedullary repair and after hardware removal, Distal Clavicle Fixation in the Skeletally Immature, Decision-making in the treatment of diaphyseal clavicle fractures: is there agreement among surgeons? While of the ball-and-socket variety, the shoulder-joint relies chiefly upon muscular support, and thus, while great latitude of movement is permitted, it also is prone to dislocation. Above images from WikiRadiography (WetPaint) here. Failure following arthroscopic Bankart repair for traumatic anteroinferior instability of the shoulder: is a glenoid labral articular disruption (GLAD) lesion a risk factor for recurrent instability? Shoulder-joint 171 Elbow-joint 172 Radio-ulnar Articulations . Injuries resulting from dysfunction are common and potentially debilitating. There are several modifications to this approach to increase exposure, such as coracoid or clavicle osteotomy or anterior deltoid release. Glenohumeral joint - a shallow cavity (hole) in the scapula where the humerous sits. Injuries resulting from dysfunction are common and potentially debilitating. Surgical Anatomy of the Sternoclavicular Joint: A Qualitative and Quantitative Anatomical Study, A Tensionable Suture-based Cerclage Is an Alternative to Stainless Steel Cerclage Fixation for Stabilization of a Humeral Osteotomy During Shoulder Arthroplasty, Arthroscopic Fixation of an Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA) of the Shoulder, Complications and implant survivorship following primary reverse total shoulder arthroplasty in patients younger than 65 years: a systematic review, The effect of glenosphere lateralization and inferiorization on deltoid force in reverse total shoulder arthroplasty, Biomechanical and Histopathological Analysis of a Retrieved Dermal Allograft After Superior Capsule Reconstruction: A Case Report, Optimal management of symptomatic os acromiale: current perspectives, Nonoperative treatment of five common shoulder injuries: A critical analysis, Arthroscopic Repair of Humeral Avulsion of the Glenohumeral Ligament Lesion, Impact of Arthroscopic Lateral Acromioplasty on the Mechanical and Structural Integrity of the Lateral Deltoid Origin: A Cadaveric Study, The Effects of Arthroscopic Lateral Acromioplasty on the Critical Shoulder Angle and the Anterolateral Deltoid Origin: An Anatomic Cadaveric Study, Quantitative MRI characterization of arthroscopically verified supraspinatus pathology: comparison of tendon tears, tendinosis and asymptomatic supraspinatus tendons with T2 mapping, Technique and Outcomes of Arthroscopic Scapulothoracic Bursectomy and Partial Scapulectomy, The Influence of Arm and Shoulder Position on the Bear-Hug, Belly-Press, and Lift-Off Tests, Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain, Chronic Plasma Cell Osteomyelitis of the Humerus Associated with Shigella and Flavobacterium, Coracoid Impingement-The Association Between Coracohumeral Interval Narrowing and Anterior Shoulder Pathologies, Factors Influencing Intra-Articular Fluid Temperature Profiles with Radiofrequency Ablation, Patient Expectations Before Arthroscopic Shoulder Surgery: Correlation with Patients’ Reasons for Seeking Treatment, The Steadman Philippon Research Institute. Acromio-clavicular joint (AC joint) The Gleno-humeral joint consists of the bony articulation between the head of the humerus (arm bone) and the glenoid, which is the socket of the scapula (shoulder blade). The shoulder is one of the most sophisticated and complicated joints of the body. Functional Limitations as Measured by the ASES Score for Patients that Present With Rotator Cuff Pathology, Functional Outcomes Following Rotator Cuff Repair Based on Tissue Quality: A Pilot Study, Improved outcomes with arthroscopic repair of partial-thickness rotator cuff tears: a systematic review, Irreparable Rotator Cuff Tears: Restoring Joint Kinematics by Tendon Transfers, Long-Term Survivorship and Outcomes After Surgical Repair of Full-Thickness Rotator Cuff Tears, Massive Rotator Cuff Tears: Pathomechanics, Current Treatment Options, and Clinical Outcomes, Mattress Double Anchor Footprint Repair: A Novel, Arthroscopic Rotator Cuff Repair Technique, Minimum Five-year Outcomes and Clinical Survivorship for Arthroscopic Transosseous-equivalent Double-row Rotator Cuff Repair, Minimum 2-year clinical outcomes after superior capsule reconstruction compared with reverse total shoulder arthroplasty for the treatment of irreparable posterosuperior rotator cuff tears in patients younger than 70 years, MRI T2 mapping of the asymptomatic supraspinatus tendon by age and imaging plane using clinically relevant subregions, One of the Most Complicated Joints in Your Body: Prevention and Treatment for Common Rotator Cuff Injuries. I can't adequately express my most sincere thanks to Dr. Millett and his entire team. The Anatomy of the Shoulder. Shoulder instability is a problem that occurs when the structures that surround the shoulder joint do not work to keep the ball tightly within its socket. Inflammation and swelling of the subacomial bursa is called busitis and is often associated with Subacromial Impingement of the Shoulder. The most flexible joint in the entire human body is the shoulder joint; this is due to a synergistic action of four separate articulations: the glenohumeral, acromioclavicular, sternoclavicular, and scapulothoracic joints . Shoulder instability is a chronic condition that causes frequent dislocations of the shoulder joint. Coraco-acromial ligament (CAL) - this is a bridge linking the coracoid to the acromion. Outcomes After Open Revision Repair of Massive Rotator Cuff Tears With Biologic Patch Augmentation, Patch-Augmented Latissimus Dorsi Transfer and Open ReductioneInternal Fixation of Unstable Os Acromiale for Irreparable Massive Posterosuperior Rotator Cuff Tear, Patch-Augmented Rotator Cuff Repair and Superior Capsule Reconstruction, Posterosuperior Rotator Cuff Tears: Classification, Pattern Recognition, and Treatment, Predictive Modeling to Determine Functional Outcomes After Arthroscopic Rotator Cuff Repair, Predictors of outcomes after arthroscopic transosseous equivalent rotator cuff repair in 155 cases: a propensity score weighted analysis of knotted and knotless self-reinforcing repair techniques at a minimum of 2 years, Prognosis Driven Rehabilitation After Rotator Cuff Repair Surgery. 181 West Meadow Drive Interference Screw vs. Suture Anchor Fixation for Open Subpectoral Biceps Tenodesis: Does it Matter? World Class Surgeon with Amazing Facility and Staff, Medical Second Opinion Service – MRI/X-Ray Review, Acromioclavicular Joint Disorders Separation, Arthroscopic Acromioclavicular Joint Treatment With Coracoclavicular Fixation and Allograft Coracoclavicular Ligament Reconstruction for Acute Acromioclavicular Dislocations, Optimal Management of Acromioclavicular Dislocation: Current Perspectives, The acutely injured acromioclavicular joint – which imaging modalities should be used for accurate diagnosis? ", Mr. S. (28), Romania, ankle patient: "What impressed me, was the high experience of the surgeons", Mr. A, (78), Egypt, knee patient: "Didn’t seek other offers as it was highly recommended by a friend. Glenoid Labrum - the shoulder joint is a ball and socket joint, but a shallow one, covering only about a third of the "ball" (head of the humerous). He's remarkable, and has truly saved an essential activity for me. If this ligament thickens it can cause impingement syndrome. T he joints of the shoulder com plex have to rely on adjacent ligam ents and m uscles to provide stability. View Media Gallery. See a charcot joint of the shoulder here. Also available from Amazon: Surgical Anatomy. Patients with shoulder instability often complain of an uncomfortable sensation that their shoulder m… The glenohumeral articulation is a versatile joint that requires a complex integration of bony ligamentous, musculotendinous and neurovascular sutures for proper function. I now have tremendous, pain-free flexibility and strength after a failed surgery in Michigan. Full Article: Surgical Anatomy of the Shoulder, Peter Millett, MD To allow such a wide range of movement, shoulder joints need to be able to move freely rather than being fixed, but require a system of complex ligaments and muscles to keep it in the correct place. If the joint comes completely out of place, this is called a shoulder dislocation. The tendon of one of these muscles - the supraspinatus is the one most likely to cause shoulder problems, both from overuse and from trauma. Scapulothoracic joint - where the scapula meets the ribs at the back of the chest. shoulder complex, the glenohumeral joint which is the fourth anatomical joint. Osteology. . The technique of joint replacement uses implants typically made from polyethylene (plastic) and metal alloy to replace the damaged sections of bone and cartilage in the joint. Arthroscopic Surgical Approaches and Intraarticular Anatomy of the Equine Shoulder Joint Arthroscopic Surgical Approaches and Intraarticular Anatomy of the Equine Shoulder Joint BERTONE, ALICIA L.; MclLWRAITH, C. WAYNE 1987-07-01 00:00:00 MS and c. WAYNE McILWRAITH, BVSc, PhD, DiplornateACVS Arthroscopic approaches to the scapulohumeral joint were developed in four clinically … This gives rise to the alternate name for the shoulder joint – the glenohumeral joint. The capsule bridges the gap across the bicipital groove, forming a structure known as … The shoulder is made up of two joints, the acromioclavicular joint and the glenohumeral joint. The biceps tendon is a common source of shoulder pain and it can rupture. The co ordinated activity of numerous muscles working together in patterns is necessary to achieve this. HONcode standard for trustworthy health information:. Clinical Results After Conservative Management for Grade III Acromioclavicular Joint Injuries: Does Eventual Surgery Affect Overall Outcomes? Joints are where 2 or more bones meet. A fall on the point of the shoulder can rupture these ligaments leading to dislocation of the AC joint. AAOS. The bony, joint, and muscular structures, the arteries, the veins and the nerves supplying the elbow are described and illustrated in textbooks and atlases in the context of the comparative anatomy. Four joints make up the shoulder joint. It is best to avoid frequent shoulder movement, however, total immobilization should be avoided. Prevalence of Shoulder Labral Injury in Collegiate Football Players at the National Football League Scouting Combine, Traumatic Rupture of the Coracobrachialis Muscle, Anatomy, Function, Injuries, and Treatment of the Long Head of the Biceps Brachii Tendon, Biomechanical Evaluation of Shear Force Vectors Leading to Injury of the Biceps Reflection Pulley, Surgical Anatomy of the Triceps Brachii Tendon, Surgical Anatomy Of The Triceps Brachii Tendon Insertion: Anatomic Study And Clinical Correlation, An association between the inferior humeral head osteophyte and teres minor fatty infiltration: evidence for axillary nerve entrapment in glenohumeral osteoarthritis, Arthroscopic Transcapsular Axillary Nerve Decompression, Arthroscopic Trans-capsular Axillary Nerve Decompression: Indication and Surgical Technique, Conjoint Tendon Tenotomy for Glenoid Exposure in the Setting of Previous Coracoid Transfer, Spinal Accessory Nerve Injury After Rhytidectomy (Face Lift): A Case Report, Suprascapular Nerve Entrapment: Technique for Arthroscopic Release, Minimum 5-Year Outcomes and Return to Sports After Resection Arthroplasty for the Treatment of Sternoclavicular Osteoarthritis, Shoulder Osteoarthritis: Diagnosis and Management, Analysis of Transfusion Predictors in Shoulder Arthroplasty, Biomechanical and Clinical Evaluation of a Novel Lesser Tuberosity Repair Technique in Total Shoulder Arthroplasty, Comprehensive Arthroscopic Management (CAM) Procedure: Clinical Results of a Joint-Preserving Arthroscopic Treatment for Young, Active Patients With Advanced Shoulder Osteoarthritis, Degenerative Shoulder Disease: Diagnosis and Management. 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