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The Right Decision for Shoulder Surgery

Shoulder pain surgery should not be taken lightly because the shoulder is the most complex joint in the body. Rather than just one joint the entire set of muscles, nerves, and joints involved in moving our upper extremities is called the shoulder complex.

Rotator Cuff Surgery Types


Shoulder pain surgery may involve many different procedures- one of the most common shoulder surgeries currently performed is acromioplasty which many patients know more commonly as removal of a bone spur. Because this is an operation that is relatively more commonly performed than many other operations in the shoulder, patients tend to assume that all shoulder surgery is relatively simple and common. Surgeons may also have some pressure to avoid discussing their level of experience or skill level with a particular procedure because they know patients strongly prefer arthroscopic shoulder pain surgery.

Failed Surgery

Unfortunately, failed acromioplasty is also something we are seeing with increasing frequency as comprehensive correction for shoulder problems frequently requires several different shoulder procedures at the same time and the astute shoulder surgeon must be prepared to evaluate and address any and all possibilities encountered. Failed shoulder surgery can be very frustrating, and one of the primary factors to consider is the diagnosis and indications-what is the true cause of your shoulder pain? Depending on your diagnosis, removal of a bone spur may be a poor choice.

Arthroscopic Acromioplasty Technique

First proposed in the 1970s, the theory that the body develops a spur that gradually rubs or reduces the space for the rotator cuff leading to a rotator cuff tear is now in doubt and surgeons disagree whether the procedure is needed in most cases.. Dr. J. Brox, who published a study about acromioplasty, is also quoted in Forbes magazine, “You can do a lot of these in a short period of time,” says Dr. Brox of Oslo. “It’s an easy way to make money, even in Norway.” Dr. Thomas Sampson was one of the first to describe an arthroscopic acromioplasty technique in 1991.

If the diagnosis and decision for shoulder pain surgery for a relatively common procedure like acromioplasty can be this difficult, consider the complexity involved with the diagnosis and treatment of just a few of the many other shoulder problems we treat like rotator cuff tear, frozen shoulderSLAP Lesion (Labrum Tear), dislocationarthritis, and separations.

Choosing a Shoulder Surgeon

Make sure you are comfortable with the diagnosis and plan before moving ahead with shoulder pain surgery. Medicine has become increasingly complex so it is important to do your homework before making the leap to shoulder surgery. Finding the right specialist for your shoulder pain surgery can be very difficult. Here are more tips on finding a good doctor, the best orthopedic surgeon and the right shoulder specialist for your shoulder pain surgery. Consumer Reports also suggests some smart ways to choose a surgeon.

As many of our patients have had previously unsatisfactory shoulder procedures, shoulder surgery in our practice often involves several procedures, rather than just one, because most patients have multiple reasons for their shoulder pain. The ability to diagnose and treat multiple areas of pathology is just one of the many advantages of modern advanced arthroscopic shoulder surgery techniques. However, these advanced techniques are still exceedingly difficult for most orthopedic surgeons to perform reliably leading to significant controversy regarding the best approach and increased complications for patients during the learning curve for surgeons. Based on the complexity of the shoulder, shoulder arthroscopy has a steep learning curve.

Once you are comfortable with the diagnosis, it is important to pick the best surgeon for you personally. Avoiding surgical mistakes starts long before you get to the operating room. Trust but verify that your surgeon has extensive experience and skill performing the specific procedure you are considering. Look for a surgeon that performs the shoulder pain surgery you are considering routinely (at least 50 times a year). Because the learning curve for shoulder surgery is so steep, it is also very difficult for the occasional surgeon to retain arthroscopic shoulder surgery skills.

To get the best results, we recommend you take an active role in your medical care.

Ask a lot of questions and maintain a healthy dose of skepticism until you feel fully comfortable with the proposed treatment plan. A little research and work ahead of time will allow you to more reliably reach the pain free function you want after shoulder pain surgery.

Vivek Agrawal, MD

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