Sub-acromial impingement syndrome (Acromioplasty)
This is rotator cuff pathology, and especially of the supraspinatus tendon, which can affect both young athletes and older people. The supraspinatus tendons protect the humeral head and are located just below the acromion, creating the sub-acromial space which is protected by a synovial bursa.
When lifting the hand upwards, the sub-acromial space is reduced and the rotor tendon is injured. This can worsen over time resulting in painful inflammation that can even lead to a rotator cuff tear. The causes that can lead to it are the shape of the acromion and mainly its anterior surface, the presence of osteophytes and any muscle atrophy that can be caused by injuries resulting in a continuous impact of the tendon on the sub-acromial space. The treatment of the sub-acromial impingement syndrome can be conservative or surgical – arthroscopic in case of persistent symptoms.
Acromioclavicular joint arthritis (Shoulder Arthritis)
Shoulder arthritis causes severe pain and inability to move the shoulder and needs treatment.
The acro-key joint is the point of contact between the key and the front through the region of the apron. This area is normally characterized by a short interval which enables the collar to be traversed and contributes to the composite shoulder movement.
With the passage of time in young athletes but mainly at older ages, due to the repeated friction of the area, degeneration – arthritic arthritis in the presence of osteophytes may occur. This arthritis causes severe pain and inability to move the shoulder and needs to be treated. Shoulder arthritis surgery is in place after conservative treatment failure and arthroscopic technique can deliver excellent results.
Shoulder instability treatment (Bankart lesion) – Shoulder Dislocation
The glenohumeral joint is anatomically an unstable joint. Dynamic and static factors contribute to the stability and ability of the wide range of motion that characterizes it. These are the rotator cuff muscles and the shoulder ligaments. During possible injuries of the upper extremity, usually in abduction and outward rotation, a dislocation of the humeral head out of its glenoid cavity may be caused. This may happen more often in the anterior direction (anterior dislocation) and less often in the posterior direction. In some young people, idiopathic shoulder joint laxity may contribute to the more frequent presence of arthritis. Shoulder instability is a pathology that needs treatment in young people. Results are better when shoulder instability is treated early and arthroscopic treatment is the method of choice. In some special cases, open surgical intervention is indicated.
Treatment of damage to the long head of the biceps (slap lesion)
The biceps long head tendon is a very strong tendon and is one of the two tendons of the biceps muscle. The biceps long head tendon contributes to the stability of the biceps head in relation to its glenoid cavity. The biceps long head tendon is in contact with the rotor cuff tendons and is anatomically fixed to the humerus in the biceps groove. It adheres to the upper part of glenoid cavity and is in direct contact with the labrum. After prolonged use and repeated minor injuries, it can produce inflammation with severe pain symptoms both during movement and at rest. Especially in the elderly, there is a degeneration of tendon fibers which can be easily treated with very good arthroscopic results by the biceps tenotomy method. In cases where rotator cuff damage is present, arthroscopic tenodesis of the long biceps head and repair along with the rotator cuff damage can always be performed. In young athletes, mainly in throwing sports, the pathology of the detachment of the biceps long head tendon from the glenoid rim (SLAP LESION) is observed frequently, which can be treated only arthroscopically with good results and reintegration of the athletes.
Calcific tendonitis
Calcium deposition (shoulder tendonitis) is associated with a very painful shoulder condition. Shoulder tendonitis mimics the symptoms of the shoulder impingement syndrome with intense pain that does not easily subside with conservative treatment. Symptoms of shoulder tendonitis can last from 1 week to over a month. Deposition of calcium on the rotor pedal mass and the accompanying bursitis causes the above symptomatology.
After conservative treatment (anti-inflammatory drugs – physiotherapy – topical injections of cortisone) the symptoms subside without the need for radiological elimination of calcification. In persistent conditions that do not respond to conservative treatment, arthroscopic treatment has excellent effects on shoulder tendonitis.
