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What’s New in Minimally Invasive Shoulder Surgery?

Summit sports medicine and shoulder surgery expert Michael Freehill, M.D., discusses the latest advancements in minimally invasive shoulder surgery.

The shoulder joint is special. It’s the only joint in the body capable of rotating 360 degrees. It enables a wide range of motion. That makes it possible for people to do everything from throwing a ball to reaching into a car’s back seat. This wide range of motion, however, comes at a cost: the should joint can become damaged or unstable relatively easily. That’s why minimally invasive shoulder surgery has proved to be such a useful approach.

What is minimally invasive shoulder surgery?

Minimally invasive shoulder surgery, also called shoulder arthroscopy, uses a tiny camera and small instruments inserted into the shoulder through several dime-sized incisions. The technology has evolved rapidly over the last two decades.

“Twenty years ago, we were making larger incisions into the shoulder. We were detaching muscle from bone to expose a fracture or rotator cuff tear, and then having to reattach them. It was an invasive approach that led to postoperative pain and dysfunction for the patient, often for an extended period,” said Summit shoulder surgeon Michael Freehill, M.D. “Now we’re treating more and more patients with minimally invasive techniques, not just for rotator cuff injuries but for fractures and dislocations as well.”

The advantages of a minimally invasive surgical approach include less discomfort for patients, less damage to the shoulder’s anatomy, faster healing, and less scar tissue — all with the same quality result as an open procedure.

What’s new in minimally invasive shoulder surgery

Within the burgeoning field of minimally invasive shoulder surgery, there are additional innovations. Here is an overview of two of the most exciting new technologies, according to Dr. Freehill:

Biologics — the next frontier, still in the research stage, involves combining minimally invasive surgery with biologic implants that enhance patients’ healing. During the surgery, the physician can place biologic agents near the repair site to stimulate a tendon to heal or to enhance blood flow, which will speed healing. “There have been some early advances with these technologies, such as platelet-rich plasma, or PRP. They will become more widely available in the field in the future,” Dr. Freehill said.

Knotless implants — this is a newer technique used with fixation. Knotless implants don’t require the surgeon to leave knots in suture material. “It has the potential to reduce complications related to large suture material in the joint itself. It also reduces the chance of having materials that could damage the joint if they come loose,” Dr. Freehill said.

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