Clinique Arago

Shoulder surgery

Shoulder surgery treats all shoulder pathologies. It has developed considerably with shoulderarthroscopy, both in terms of understanding the pathological mechanisms and the technical possibilities for treatment.
Nowadays, most shoulder surgery is performed under arthroscopy: rotator cuff repair, acromioplasty, biceps tenotomy and tenodesis, arthroscopic Bankart, acromioclavicular disjunction and dislocation, acromioclavicular arthroplasty, and so on.
Open treatment, i.e. open surgery, continues to have its uses, particularly in shoulder stabilisation with the shoulder block, although recent arthroscopic techniques are beginning to be developed, and of course all prosthetic surgery.
Shoulder prostheses fall into two categories: anatomic total shoulder prostheses for arthritic shoulder conditions where the cuff tendons are still intact, and inverted total shoulder prostheses for all cases of arthrosis or joint destruction where the cuff tendons are absent or severely deficient.

The function of the shoulder

The shoulder serves as the connection between the trunk and the upper limb and, thanks to its great mobility - the greatest in the human body - allows the upper limb to be positioned in all three dimensions of space, enabling the hand to perform its gripping function. The shoulder is a complex joint with a strong musculature (19 muscles in total) that enables it to move its three component joints, the main one being the glenohumeral joint (between the humerus and the scapula), the acromioclavicular joint (between the scapula and the clavicle) and the sternoclavicular joint (between the clavicle and the sternum), and to slide the scapula over the rib cage.The shoulder joint is strong, flexible and highly mobile, but it is undoubtedly the most stressed joint in the human body during daily, sporting and professional activities (pushing, pulling, carrying, lifting, throwing, holding....). This makes it particularly vulnerable to trauma and wear.

Shoulder surgery and pathologies

Broadly speaking, shoulder pathologies can be divided into three main categories:

Shoulder instability :

Sports pathology par excellence. The very great mobility of the shoulder joint is made possible by the particular osteoligamentous architecture of the glenohumeral joint, a humeral head in the shape of a sphere (tennis ball) and a glenoid, small and flat slightly larger than a two-euro coin attached together by the joint capsule, the labrum and the glenohumeral ligaments. The other side of the coin is a strong tendency for the humeral head to pop out of its socket, resulting in dislocation of the shoulder or subluxation if it is partial. They are mainly encountered in sports traumatology and in young people (< 40 years old).

Tendon pathology :

The most frequent tendon pathology and the most seen in daily shoulder surgery practice. It affects the tendons of the rotator cuff. Unlike hip and knee surgery, the shoulder is worn down by its tendons, ranging from simple tendonitis without tendon rupture to massive, large, non-repairable rupture of the rotator cuff tendons, passing through various stages of repairable lesions (in the end, the most frequent). Rotator cuff tendinopathies are usually seen after the age of 40-45, and the main symptom is shoulder pain.

Osteoarthritis of the shoulder or omarthrosis:

This affects the joint between the humerus and the shoulder blade. Broadly speaking, there are two types of shoulder osteoarthritis:

  • shoulder osteoarthritis with intact rotator cuff (primary, osteonecrosis of the humeral head, certain fracture sequelae, etc.)
  • osteoarthritis of the shoulder with destruction of the rotator cuff (due to massive rupture of the tendons, certain fracture sequelae, etc.).
  • Find out more on our page dedicated to KNEE shoulder prosthesis.


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