Shoulder Specialists

Shoulder Conditions Treated

  • AC Joint injuries and AC Separation
  • AC Joint Arthritis
  • Proximal Biceps Injuries
  • Biceps Tendonitis
  • Clavicle Fractures
  • Calcific Tendonitis
  • Frozen Shoulder
  • Labral Tears
  • Multidirectional Instability
  • SLAP Tears
  • Rotator Cuff Tears
  • Shoulder Dislocations and Instability
  • Shoulder Arthritis
  • Shoulder Fractures and Proximal Humerus Fractures
  • Subacromial Impingement
Shoulder Conditions Treated at Ortho Sports Medicine in Downtown Portland

Shoulder Procedures Performed

Shoulder Arthroscopy

During a shoulder arthroscopy, Dr. Petit will make a few small incisions on the front, back and side of the shoulder. Using a small high definition camera, the joint is evaluated and needed procedures are performed. Recent technologic advances have allowed many shoulder procedures to be performed arthroscopically.

AC Separation Treatment and AC Joint Reconstruction

AC joint reconstruction is a procedure usually reserved for only the most severe AC joint separations. Usually Dr. Petit uses a combination of arthroscopic and open surgery to realign the AC joint and hold it in place. In cases where the AC joint has been injured for a significant period of time, a cadaver graft is often needed to enhance healing.

Biceps Tenodesis

When the biceps tendon becomes inflamed or torn, Dr. Petit prefers to perform a biceps tenodesis. The biceps tendon’s normal attachment point is at the superior labrum within the shoulder joint. It passes between two rotator cuff tendons as it enters the joint and is often damaged when the rotator cuff is damaged or torn. When this occurs, Dr. Petit releases the biceps from within the joint and reattaches the tendon to the humerus, underneath the pectoralis muscle, through a small incision in the armpit.

Clavicle Fracture Fixation or ORIF Clavicle

When a patient suffers a displaced clavicle fracture, Dr. Petit prefers to perform an open reduction and internal fixation of the fracture. Traditionally, clavicle fractures were treated without surgery and allowed to heal on their own. However research has shown that surgical treatment has better results for displaced fractures with minimal risk. This typically involves an incision over the front of the clavicle and a plate and screws are used to hold the clavicle in place while the bone heals.

Capsular Release and Manipulation for Frozen Shoulder

Frozen shoulder, or adhesive capsulitis, is an extremely common condition for middle aged men and women. Most of the time, non operative treatment such as physical therapy and steroid injections are successful in restoring motion. Occasionally, non operative measures do not work and the shoulder needs a little help getting motion back. Dr. Petit prefers an arthroscopic approach where the tight tissue is precisely released and the shoulder gently manipulated to gain range of motion back. Aggressive, daily physical therapy is required postoperatively. Often patients resume normal activities within days of surgery.

Arthroscopic Subacromial Decompression

During this procedure, Dr. Petit uses small arthroscopic instruments to remove any bone spurs causing impingement or damage to the rotator cuff.

Arthroscopic Distal Clavicle Excision (Mumford Procedure)

During this procedure, Dr. Petit uses small arthroscopic instruments to access the acromioclavicular joint. A small amount of bone is cleared from the joint to remove impingement on the underlying rotator cuff and keep the clavicle and acromion from rubbing and causing pain.

Arthroscopic Rotator Cuff Repair

The newest technological advances in cameras and surgical instruments have allowed Dr. Petit to perform nearly all rotator cuff repairs arthroscopically. This leads to decreased pain post operatively. Despite the procedure being minimally invasive, the rotator cuff tendon still takes a significant amount of time to heal. Most patients will need to avoid any active shoulder motion for 6 weeks after surgery.

Superior Capsular Reconstruction for Irreparable Rotator Cuff Repair

Superior capsular reconstruction is a procedure where a piece of cadaver skin is anchored in the shoulder to keep the shoulder joint centered when the rotator cuff is not reparable. It is an operation reserved for younger patients with an irreparable rotator cuff tear. Popularized in Japan prior to them having access to the reverse total shoulder, this operation has recently gained popularity in the US to treat rotator cuff disease. Learn more about the superior capsular reconstruction here (link to Arthrex scr)

Ultrasound Guided Calcific Tendonitis Lavage

For some patients suffering from calcific tendonitis, Dr. Petit can find the calcium using ultrasound and place one or two large needles in the calcium deposit and break the deposit up. Occasionally, Dr. Petit is able to suck out a portion of the calcium. This procedure is usually combined with a steroid injection to decrease inflammation and pain.

Ultrasound Guided Injections

The addition of ultrasound to our office has completely changed our diagnostic and therapeutic abilities. In just a few minutes Dr. Petit can often diagnose rotator cuff tears, biceps tendon problems, and shoulder impingement. Using the ultrasound he can place injections more precisely and safely than the traditional method. ?sonosite link?

Total Shoulder Replacement

Total shoulder replacement is Dr. Petit’s preferred treatment for shoulder arthritis for patients with an intact rotator cuff and no or minimal bone deformity. The operation can be performed on either an outpatient basis or with an overnight stay. Dr. Petit’s mentor and former partner, Dr. Paul Switlyk, pioneered shoulder replacement in the state of Oregon and Dr. Petit aims to continue his dedication to excellence in the field. Learn more about total shoulder replacement here (link to biomet tsa)

Reverse Total Shoulder Replacement

Reverse Total shoulder replacement is Dr. Petit’s preferred treatment for shoulder arthritis for patients with a previous rotator cuff tear or with significant bone deformity. It is also used for patients over 60 with an irreparable rotator cuff tear who do not have arthritis. The reverse total shoulder is the preferred implant for most revision or redo shoulder replacements. In this operation the “ball and socket” are reversed allowing the deltoid, pectoralis and surrounding muscles to do the work of the rotator cuff. Learn more about reverse total shoulder replacement here (link to biomet reverse tsa)

Revision Total Shoulder Replacement

Revision or redo shoulder replacement is an incredibly complex procedure used when a previously performed shoulder replacement has failed. Dr. Petit is one of the few surgeons in the state that performs revision shoulder replacements routinely. Often these operations require complex bone grafting and in some cases a custom 3D printed implant is used. Learn more about that here (link to biomet VRS)

Latarjet Procedure

The Latarjet procedure is an open procedure used to stabilize the shoulder. Dr. Petit uses this procedure when there is bone loss associated with a shoulder dislocation. During this procedure a piece of bone called the coracoid is harvested and attached to the front of the glenoid (shoulder socket) to enhance stability.

SLAP Repair

SLAP tears (Superior Labrum Anteiror-Posterior) occur commonly in competitive overhead athletes (baseball, tennis, volleyball, rock climbers) and patients who do any repetitive overhead motion. These tears are managed either by biceps tenodesis or arthroscopic labral repair.

Bankart Repair (Anterior Labral Repair)

When the shoulder dislocates out of the front of the shoulder, the labrum detaches from the front of the shoulder socket. Dr. Petit can reattach the labrum and repair the damaged shoulder ligaments arthroscopically through 3 small incisions.

Capsulorrhaphy

This procedure is where the capsule is “tightened” for shoulder instability. Somewhat synonymous with the Bankart repair. Often in cases with multidirectional instability, Dr. Petit will perform a Capsulorrhaphy where the whole shoulder capsule is tightened.

Posterior Labral Repair

Posterior labral tears can occur over time with repetitive use (throwers, swimmers, tennis players) or from a traumatic posterior (out the back) dislocation. In the setting of a posterior labral tear, Dr. Petit will arthroscopically repair the posterior labrum using sutures attached to anchors which are drilled into the glenoid bone.

Fixation of Proximal Humerus Fracture (Orif Proximal Humerus Fracture)

Severe shoulder injuries often result in fractures to the upper arm bone (proximal humerus fractures). Many of these injuries can be treated without surgery. For those that need surgery, Dr. Petit most often uses a plate and screw construct with or without bone graft to secure the bones while they heal. Occasionally these fractures cannot be reconstructed with a plate and screws and need a replacement.