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.
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.