Shoulder

A minimally-invasive and technically advanced procedure called Superior Capsular Reconstruction (SCR) surgery is being used at St. Jude’s Orthopedic Institute to successfully repair massive rotator cuff tears. This innovative outpatient procedure reconstructs the shoulder capsule, using donor tissue from a tissue bank to restore the correct position of the shoulder and stabilize the shoulder socket. 

Patients typically experience significantly improved range of motion and functionality as well as decreased pain. This biologic and joint-preserving solution offers an important alternative to total shoulder replacement.  

A separated shoulder, also called an acromioclavicular or AC joint separation, is a common sports injury and although most can be managed conservatively, some require surgery. If the clavicle is elevated by more than 100 percent of the width of the bone, the treatment is typically surgical.

Until recently, this involved a large open approach where every muscle group attached to the clavicle had to be taken down, the AC ligaments reconstructed, and the muscle groups reattached. Today, the procedure is performed arthroscopically through three small poke holes or incisions—while leaving the muscle groups in place. Offering equal or better outcomes, this less-invasive procedure is significantly reducing pain, complications and recovery times.

The key for arthroscopic repair is to treat the injury within the first 30 days, so it’s important to be evaluated without delay. 

Rotator cuff injuries and tears are very common, often affecting relatively young and active patients. Our orthopedic surgeons specialize in arthroscopic repair, one of the most important advances in treating these tears. 

Instead of the traditional open surgery or mini-open approach in which muscle is detached, our surgeons successfully repair this injury through three to four very small puncture wounds during an outpatient procedure.  By preserving the deltoid muscle, most patients experience better range-of-motion, accelerated rehabilitation, as well as less pain and scarring.

Until very recently, large tears remained non-repairable and the only option for patients was reverse shoulder replacement. At St. Jude, an innovative technique allows us to arthroscopically reconstruct the shoulder capsule and re-attach it to both the shoulder socket and the upper end of the humerus bone. Over 90 percent of patients experience significantly improved range of motion and functionality as well as decreased pain – making this procedure a true breakthrough in the field of shoulder surgery.   

For those with a torn rotator cuff and shoulder arthritis, simply raising their arm can be extremely painful, if not impossible. A new and innovative shoulder replacement surgery features a reverse ball/socket technique that can dramatically lessen pain and improve function—even for patients with extensive rotator cuff damage, instability or a previous failed surgery.  

In the healthy shoulder, the upper arm bone (humerus) ends in a ball shape which fits into a socket formed by the shoulder blade (scapula). With a reverse shoulder replacement, the anatomy, or structure, of the healthy shoulder is reversed: the ball portion is attached to the scapula and the socket is placed at the upper end of the humerus.

By reversing the ball and the socket, the deltoid muscle (the large shoulder muscle) becomes more efficient and often compensates for the torn rotator cuff—allowing patients to regain their range of motion and quality of life.  

This joint-preserving procedure replaces just the head of the humerus (the ball), allowing the healthy socket (glenoid) to remain. Younger, active patients with limited joint degeneration may also be candidates for resurfacing, in which the head of the humerus is capped with a metal prosthesis. By preserving the healthy structures of the shoulder, these minimally-invasive options offer more rapid rehabilitation and return to function.