Introduction to shoulder surgery

Question 1

Why is shoulder pain important?

Answer 1

3rd most common MSK consultation in GP practice

1% adults each year visit GP with shoulder pain

25% of adults self reported prevalence of shoulder pain

Question 2

List some risk factors for shoulder pain

Answer 2

Sports related injuries
Traumatic injuries
Degenerative conditions
Work related condition

Question 3

List some common shoulder symptoms

Answer 3

Pain
Stiffness
Weakness
Instability

Question 4

List some causes of shoulder pathology in the glenohumeral joint

Answer 4

Arthritis
Instability
Frozen Shoulder

Question 5

List some causes of shoulder pathology in the rotator cuff muscles

Answer 5

Tears
Bursitis
impingement
calcific tendonitis

Question 6

List some other causes of shoulder pathology

Answer 6

Bone trauma

Question 7

Name the bones which form the shoulder region

Answer 7

Clavicle
Scapula
Humerus

Question 8

What is the function of the shoulder?

Answer 8

Designed for a range of movement

Question 9

Describe the stability of the shoulder joint

Answer 9

Inherently unstable

Question 10

What stabilises the shoulder joint?

Answer 10

Rotator cuff (dynamic) 
Capsule and labrum (static)

Question 11

Name the rotator cuff muscles

Answer 11

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 12

What do all the rotator cuff muscles form?

Answer 12

Rotator cable

Question 13

What is the importance of the rotator cuff muscles forming the rotator cable?

Answer 13

Gives it more strength

Question 14

Describe rotator cuff biomechanics

Answer 14

As the rotator cuff muscles fire they produce a force
Moves the humeral head towards the socket
Keeps it pressed against the socket

Question 15

What is the function of the rotator cuff?

Answer 15

Stabilise the glenohumeral joint

Provide a fulcrum for power muscles to move the arm

Question 16

Name the muscles which function with rotator cuff

Answer 16

Deltoid
Pectoralis minor
Pectoralis major
Latissimus dorsi 
Teres major

Question 17

Name the superficial power muscles

Answer 17

Deltoid
Pectoralis major
Latissimus dorsi

Question 18

Name some rotator cuff disorders

Answer 18

Subacrominal impingement
Rotator cuff tears
Calcific tendonitis

Question 19

Describe the prevalence of Subacrominal impingement

Answer 19

Common

Question 20

What is Subacrominal impingement?

Answer 20

Pain on abduction and rotation of the arm

Felt over the deltoid

Question 21

Name some extrinsic causes of Subacrominal impingement

Answer 21

Bony spurs

Question 22

Name some intrinsic causes of Subacrominal impingement

Answer 22

Tendiopathy/cuff weakness

Question 23

Give the non-surgical treatment of Subacrominal impingement

Answer 23

Activity modification

Physiotherapy

Question 24

Give the surgical treatment of Subacrominal impingement

Answer 24

Subacromial decompression Debridement of bony and soft tissue impinging areas

Question 25

Name the most common rotator cuff tears

Answer 25

Supraspinatus/infraspinatus

Question 26

Give the symptom of rotator cuff tears

Answer 26

Weakness and pain

Question 27

What percentage of people in their 60s have a full thickness tear?

Answer 27

15%

Question 28

When would you repair a rotator cuff tear?

Answer 28

If it is symptomatic

Question 29

List some glenohumeral disorders

Answer 29

Arthritis Frozen shoulder Instability

Question 30

Name the 3 types of glenohumeral arthritis

Answer 30

Osteoarthritis Rheumatoid arthritis Post traumatic arthritis

Question 31

List the symptoms of arthritis

Answer 31

Stiffness Crepitus & grinding Pain at rest and at night Pain with activity

Question 32

Name the two types of shoulder replacement

Answer 32

Anatomic | Reversed

Question 33

Describe anatomic shoulder replacement

Answer 33

Fulcrum for power muscles provided by rotator cuff

Question 34

Describe reversed anatomic shoulder replacement

Answer 34

Creates a mechanical fulcrum for power muscles

Question 35

Give the symptoms of frozen shoulder

Answer 35

Stiffness | Pain

Question 36

What motion is lost in frozen shoulder

Answer 36

Passive motion (external rotation)

Question 37

Describe frozen shoulder on Xray

Answer 37

Normal

Question 38

Which patients is frozen shoulder common in?

Answer 38

40-60 year olds Women Diabetics

Question 39

What is frozen shoulder?

Answer 39

Inflammation and thickening of capsule

Question 40

List the non-surgical treatments of frozen shoulder

Answer 40

Natural history is to resolve over 2 years Injections Hydro dilatation

Question 41

List the surgical treatments of frozen shoulder

Answer 41

Capsular release and manipulation

Question 42

What is the most common type of shoulder dislocation?

Answer 42

Anterior

Question 43

What happens if the shoulder dislocation occurs at young age?

Answer 43

Higher chance of recurrence

Question 44

List some risk factors of shoulder dislocation

Answer 44

Collision sports | Hyper laxity

Question 45

Name some surgical treatments of shoulder dislocation

Answer 45

Arthroscopic stabilisation - labral repair Open stabilisation - capsule tightening Bony procedures - augmenting glenoid

Question 46

Give the name of a bankart lesion

Answer 46

Anterior labral tear

Question 47

What can shoulder trauma result in?

Answer 47

fractures dislocation soft tissue injuries