{"id":146771,"date":"2019-03-01T15:09:09","date_gmt":"2019-03-01T20:09:09","guid":{"rendered":"https:\/\/today.uconn.edu\/?post_type=school-college-post&p=146771"},"modified":"2019-03-01T15:09:09","modified_gmt":"2019-03-01T20:09:09","slug":"one-shoulder-time","status":"publish","type":"post","link":"https:\/\/today.uconn.edu\/2019\/03\/one-shoulder-time\/","title":{"rendered":"One Shoulder at a Time"},"content":{"rendered":"

When it comes to the best way to repair a dislocated shoulder, the answer, like so many things in modern medicine, has evolved from \u201copen surgery\u201d to \u201cminimally invasive surgery\u201d to \u201cit depends.\u201d<\/p>\n

\"Dr.
Listen to Dr. Robert Arciero discuss shoulder instability treatment in this Connecticut Public Radio UConn Health Minute<\/a>. (Photo by Peter Morenus)<\/figcaption><\/figure>\n

\u201cNow we have open techniques, we have arthroscopic techniques, we have bone grafting techniques, and any or all of these procedures may be available to any patient at any one time, depending on the degree of instability, the amount of damage to the ligaments and the labrum and the bone,\u201d says Dr. Robert Arciero<\/a>, orthopedic surgeon and chief of the UConn Health Department of Orthopedic Surgery Sports Medicine Division<\/a>.<\/p>\n

The discipline of orthopedic surgery is moving in this direction \u2013 a well-defined understanding of which techniques work in the vast majority of cases and an acknowledgement that there often are multiple factors causing shoulder instability.<\/p>\n

\u201cThe surgeon must treat all of the problems that are treating the shoulder instability, or the surgery will fail,\u201d says Arciero, who is one of the team physicians for UConn athletics. \u201cAnd I think that\u2019s why we\u2019re seeing some increased failures, particularly in young athletes.\u201d<\/p>\n

For example, the minimally invasive arthroscopic approach is appropriate when soft tissue repair is all that\u2019s needed to stabilize the shoulder. And surgeons still can use the scope to restabilize the shoulder even when damaged ligaments, labrum, and bone are all culprits. But that\u2019s where it gets dicey \u2013 That soft tissue repair doesn\u2019t address the damaged bone, setting the patient up for recurring instability and additional surgery.<\/p>\n

As a ball-in-socket joint, the shoulder can be likened to a golf ball on a tee. Picture the rounded top end of the humerus (the bone in your upper arm) as the ball, and the cup-like socket of the shoulder blade as the tee. If there\u2019s bone damage, it\u2019s like the corner of the golf tee is worn down to the point where the ball doesn\u2019t reliably stay on the tee anymore.<\/p>\n

A patient with multiple dislocations due to torn labrum and ligaments can start to wear down the bone. And it\u2019s in those cases where a scope alone isn\u2019t enough.<\/p>\n

Those cases also are leading surgeons to believe that often it\u2019s better to intervene earlier than what historically has been done \u2013 before the additional damage occurs, and perhaps as early as after the first dislocation.<\/p>\n

\u201cHere at UConn we have surgeons who are studying this problem their whole career, and developing and defining not only the surgical techniques, but what patient needs what procedure,\u201d Arciero says.<\/p>\n

Sometimes that means a patient who had a shoulder repair done elsewhere will end up at the UConn Musculoskeletal Institute<\/a> for another surgery because the technique used the first time either failed or didn\u2019t fully address the problem.<\/p>\n

In all cases, the patient\u2019s chance at success greatly increase when the surgeon embraces this new way of thinking, understanding that the one procedure he or she was trained to rely on is not always the best approach.<\/p>\n

\u201cThe better outcomes are when we are able to appreciate all of the problems that are causing that person\u2019s shoulder to be unstable, and then we fix all of the problems,\u201d Arciero says.<\/p>\n

Learn more about orthopedics and sports medicine at the UConn Musculoskeletal Institute<\/a>, or call 860-679-6600<\/a> to schedule an appointment.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

How patients benefit from an evolving approach to addressing shoulder instability.<\/p>\n","protected":false},"author":111,"featured_media":146770,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_crdt_document":"","wds_primary_category":0,"wds_primary_series":0,"wds_primary_attribution":0,"footnotes":""},"categories":[1868],"tags":[],"magazine-issues":[],"coauthors":[2010],"class_list":["post-146771","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-meds"],"pp_statuses_selecting_workflow":false,"pp_workflow_action":"current","pp_status_selection":"publish","acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-04-15 12:07:30","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/146771","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/users\/111"}],"replies":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/comments?post=146771"}],"version-history":[{"count":0,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/146771\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media\/146770"}],"wp:attachment":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media?parent=146771"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/categories?post=146771"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/tags?post=146771"},{"taxonomy":"magazine-issue","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/magazine-issues?post=146771"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/coauthors?post=146771"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}