T.J. Samson | Destination Health | June 2018

Nonprofit Org. U.S. Postage PAID Platteville, WI Permit No. 7 T.J. Samson Community Hospital 1301 N. Race St. Glasgow, KY 42141 JUNE 2018 H ave you noticed that your arm hurts when you raise it above your head? Maybe when you’re showering or putting away dishes on a high shelf. And maybe that same shoulder aches at night when you try to sleep. If this sounds like you, it could be a rotator cuff problem—one of the most common shoulder issues. And if it turns out you need surgery (most rotator cuff problems do not), here’s good news: The surgery can usually be done in a mini- mally invasive procedure (through small incisions) at T.J. Samson Community Hospital. It’s called shoulder arthros- copy, and it can put you on the road to quicker healing. But shoulder surgery wasn’t always that way. In the 1980s, most shoulder surgeries were still done by the tradi- tional method: through a large, open incision. Gradually, surgeons began to adopt a technique that was already being pioneered in knee surgery: arthroscopy. “The scope has become the dominant player in shoulder sur- gery now,” says Barret Lessenberry, MD, an orthopedic surgeon at T.J. Samson. “The scope” is short for arthroscope. It’s a slender, lighted camera used to see inside the joint. During arthros- copy, the scope is inserted through one of three very small holes near the shoulder. Surgical instruments are inserted in the other holes.They may be used to grasp, remove or suture tissue, for instance.The surgeon controls the instruments and views the operation up close on a video screen. Because the incisions are small, shoulder arthroscopy is easier on the body. And most of the time you can go home the same day as the procedure. “The discomfort is less, the recoveries are quicker and the incidence of stiffness is much less than in the past,” says Dr. Lessenberry. COMMON (AND PAINFUL!) SHOULDER PROBLEMS A number of conditions can be treated with minimally invasive shoulder ar- throscopy. But the two most common problems are probably rotator cuff im- pingement syndrome and rotator cuff tears, says Dr. Lessenberry. Impingement occurs when the rotator cuff tendons become pinched by bone above it in the shoulder.This can lead to inflammation and painful tendinitis. To stop the pinching, a surgeon can use the arthroscope to remove a piece of the bone, making more space for the tendon to move within the shoulder. “You can alleviate the problem pretty easily with a scope,” Dr. Lessenberry says. “And the patient can use the shoul- der within two days.” A rotator cuff tear can happen over time with impingement—the tendon becomes frayed like an old carpet before it tears, Dr. Lessenberry says. Or a tear can happen suddenly due to an injury, such as a fall. In arthroscopic rotator cuff repair, the surgeon uses sutures and anchors to reattach the tendon to the bone. Recovery is longer than for an impingement repair. You’ll probably need to wear a sling to protect the shoulder for six weeks.Then you can gradually begin to use it again. SURGERY ISN’T THE ONLY OPTION Most rotator cuff problems can be treated without surgery, Dr. Lessenberry emphasizes. Other options include anti-inflammatory medicines, steroid shots or physical therapy. But if that doesn’t help and if sur- gery is needed, it’s good to know that a minimally invasive approach is available. “By doing it that way, we think we can give you an outcome as good as anything else,” Dr. Lessenberry says. “And your recovery is quicker and your discomfort is less.” The scope approach Minimally invasive shoulder surgery is easier on the body Barret Lessenberry, MD, Orthopedic Surgeon