Bursitis of The Shoulder

Bursitis of The Shoulder

Shoulder Bursitis Treatment

The shoulder joint has a fluid filled sac that becomes inflamed in bursitis of the shoulder. The inflammation causes pain and restricts normal motion. The condition doesn’t usually happen without any external trigger. Generally, bursitis of the shoulder is accompanied by rotator cuff tendonitis, which is the inflammation of the rotator cuff or shoulder tendons.

Most bursitis of the shoulder cases is treated in a non-surgical way with simple, at-home treatments. However, surgery may be the only recourse where non-surgical procedures are not effective.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Understanding Bursitis of the Shoulder

Bursa, which is part of the shoulder blade and located between the rotator cuff can develop swelling and inflammation because of excessive shoulder use. This is also called subacromial bursa. The condition is better known as subacromial bursitis.

Bursitis of the shoulder along with rotator cuff tendinitis can cause difficulty in performing everyday tasks and activities. Shoulder impingement is a common cause of bursitis of the shoulder. It occurs when the shoulder blade top starts putting pressure on the underlying soft tissues. This is when the arm is not next to the body.

The top of the shoulder blade when the arm is lifted away from the body rubs on the bursa and rotator cuff. This impingement results in bursitis of the shoulder. Gout, arthritis, diabetes, tendonitis, thyroid disease, and infection are other causes of the condition.

Non-Surgical Procedures

These are a few non-surgical treatment options:

  • Rest: You should give your shoulder complete rest. Take a break from all movements and activities that cause pain.
  • Ice: Cold pack on the shoulder may reduce swelling. You should aim for 10 to 15 minutes a day or twice a day.
  • Non-prescription medications: Motrin or Advil, Aspirin and Aleve can help in easing soreness and swelling.
  • Medications: For severe pain, the physician may inject a steroid into the shoulder bursa area. However, you may need antibiotics if the condition is caused by an infection.
  • Stretching and physical therapy: Several exercises can help your shoulder regain its normal range of motion. This will be demonstrated by your orthopedic surgeon.

Surgical Treatment for Bursitis of the Shoulder

Your surgeon may perform manual tests and take a good look at your symptoms to determine whether you have bursitis of the shoulder. Surgery is the last treatment option for bursitis of the shoulder. Surgery, if required, is usually because bursitis doesn’t respond to any non-surgical treatment options or physical therapy.

The surgical procedure typically involves removing the bursa. This makes space for a new and healthy bursa to grow in its place. The surgeon may also remove a portion of the bone to make room for the rotator cuff tendon. This will help in decreasing the rubbing or impingement occurring on the shoulder.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Broken Collarbone

Broken Collarbone Treatment

Broken collarbone or a clavicle fracture is one of the most common fractures. It usually occurs after the individual suffers a serious accident or fall. Most collarbones heal with the help of a sling. However, surgical treatments may be required in certain rare and serious cases where the bone has moved too far out to heal without medical intervention.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Understanding Broken Collarbones

Collarbones can break at any age. Almost 5% of adult fractures are broken collarbones. These fractures can be as severe as a full break or something minor like a slight crack. There can be comminuted fracture as well, which refers to multiple breaks.

Car accidents, hard falls and other things can cause the collarbone to break. Babies can suffer from broken collarbones while passing through the birthing canal. Middle portion of the bone is where most fractures take place. The bone may also break at the shoulder blade or where it meets the ribcage in certain rare cases.

The severity of your fracture will determine if the broken bones line up out of place or straight. Out of place healing or displaced fracture is a sign of serious fracture.

Treatments and Procedures for Broken Collarbone

Your orthopedic surgeon will recommend a surgery where the fracture is severe. This normally entails placing the broken pieces back into the correct position. This can help ensure you regain your lost strength.

Open reduction and internal fixation is a common procedure for treating broken collarbones. Fragments or pieces are positioned in place and held together using special metal hardware. These are a few options for internal fixation:

  • Plates and screws: Metal plates and surgical screws are used for holding the bone fragments in place. They are then attached to the bone’s outer surface. You may experience slight numbness, which will go away after a few weeks. Plates and screws are rarely removed unless they cause discomfort.
  • Pins or screws: Pins and screws can be used to hold the fracture in place once the bone ends have been repositioned. Pins and screws tend to irritate the skin and are usually removed on healing.

Your surgeon will suggest non-prescription medications and ice packs to help with the pain following surgery. You may be prescribed a prescription strength pain killer as well for a few days if the pain is severe or persistent. You should understand that rehabilitation is necessary for complete restoration and recovery of your shoulder.

Your surgeon will discuss whether you require home therapies or not. They may recommend a professional therapist as well to help you recover quickly. You will be advised to start off slowly with the physiotherapy exercises. Don’t hesitate to stop completely if there is pain or discomfort. You should also speak with your surgeon about persistent pain.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Bioinductive Implant

Bioinductive Implant to Treat Rotator Cuff Disease

Bioinductive implant is a revolutionary new procedure for treating patients that have rotator cuff disease. Tendons can heal through the Rotation Medical Bioinductive Implant by introducing new tissue growth. This helps patients perform regular activities much quicker than traditional treatments. The procedure helps in reducing the risk of re-tears and degeneration as well.

Rotation Medical Bioinductive Implant is a minimally invasive procedure for people experiencing rotator cuff tendon tears in the shoulder joint. Shoulder disability and pain are usually because of rotation cuff tears. It affects more than 3 million people in the US every year. Most patients avoid getting a surgery because it can result in a lengthy and painful postoperative period.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Understanding Bioinductive Implant

The Rotation Medical Bioinductive Implant is the size of a postage stamp. It is a collagen-based implant that is delivered through a small incision arthroscopically. The incision is made over the injured rotator cuff tendon and is closed using proprietary staples.

The implant is capable of inducing new tendinous tissue formation right over the tendon surface. It results in a thicker tendon. This is the only implant of its type to induce new tissue growth to help tendons heal faster.

The Rotation Medical Bioinductive Implant has demonstrated remarkable success rates when used early in the disease. It can easily prevent progression of the disease and reduce the risk of re-tears. The implant addresses the underlying issue of the problem – excessive strain and stress in the tendons.

How Does Rotation Medical Bioinductive Implant Work?

This is a highly porous implant which allows the new fibrovascular tissue to fully fill it. The implant comes with distinct biomechanical features, which induces new tissue growth. The tissue is remodeled into the tendon-like, linearly placed tissue.

New tissue growth is gradually absorbed within the implant over a period of six months. It leaves a layer of biologically augmented new tissue within the existing tendon.

Advantages of the Bioinductive Implant

There are several potential benefits to the Bioinductive Implant depending on the extent of rotator cuff disease. Few of these are:

  • Decreased sling time
  • Quicker recovery
  • Prevention of disease progression
  • Partial thickness tears heal quicker

Rotator Cuff Injuries Are Common in the US

One of the most common causes for shoulder pain the country is rotator cuff disease, which affects over 4 million people on an average every year. Most people avoid having a surgery done until the pain becomes unbearable.

Clinical Evidence Supporting Bioinductive Implants

Bioinductive implants are highly capable as can be demonstrated by a growing body of evidence. Multiple studies have proven that the implants are effective and safe. FDA clearance was obtained for the procedure in 2014. It has already helped thousands of patients in the United States.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Bicep Tenodesis

Bicep Tenodesis Treatment

Biceps tendonitis is usually treated with a surgical procedure called biceps tenodesis. Biceps tendonitis is also known as biceps tendon tear. The surgery is usually recommended for people that suffer from shoulder pain because of biceps tendonitis. The pain is usually caused by inflammation and doesn’t improve with non-surgical treatment.

Biceps tenodesis procedure is recommended for people looking to regain mobility and strength in their shoulder area. Damaged parts of the bicep tendon are removed during the procedure.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Symptoms of Biceps Tendonitis

Traumatic injury or repetitive movement of the shoulder may cause biceps tendon tears. Symptoms include:

  • Sharp and sudden pain in the upper arm
  • Snapping or popping sound
  • Cramping of biceps
  • Tenderness or pain in the elbow or shoulder
  • Weakness in elbow or shoulder
  • Appearance of bruises
  • Difficulty rotating the arm
  • Popeye muscle or a bulge in the upper arm

Understanding Biceps Tenodesis

This is a surgical procedure that helps in treating biceps tendonitis. Biceps tendon tear occurs because of an abrupt injury or overtime with repetitive motion. Biceps tendon may tear entirely or partially. However, a majority of people don’t require a surgery and are able to live their lives without any trouble.

You may lose some mobility and strength with biceps tendon tear in your shoulder. However, it may not be enough for you to experience difficulty in performing everyday tasks. You may need to get a surgery if you want to regain strength and mobility in your shoulder.

How Does it Work?

There are several ways of performing a biceps tenodesis procedure. Most procedures fit into soft tissue and hard tissue categories.

Soft Tissue Procedures

There are two primary techniques under this approach:

  • Open keyhole procedure: An opening in the keyhole or humerus is created. This is to insert tiny instruments for stitching the rolled-up end of the bicep into place.
  • Pitt technique: An interlocking pattern of stitches is created using two needles. The tendon is then tied to the shoulder ligament.

Hard Tissue Procedures

The two primary techniques under this approach are:

  • The surgeon will first detach the biceps tendon to create a hole at the top of the arm bone. The tendon is attached to this hole at one end. The other end is secured in place by screwing it to the arm bone.
  • The biceps tendon is detached in this approach as well. However, it is attached to a button that is slid into the hole at the top of the arm bone.

Biceps tenodesis is a highly successful procedure for the most part because it’s well practiced. People report better flexibility, reduced pain, and better strength. They also find it easy to return to their activities and sports. Experts recommend getting the procedure done at least three months after the injury for best results.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Arthroscopic Rotator Cuff Repair

Arthroscopic Rotator Cuff Repair

You can suffer from a rotator cuff tear after falling or another significant injury. Degeneration and prolonged breakdown of the associated tendon can also result in a rotator cuff tear. Pain while sleeping and radiating pain on the affected side are common symptoms of a rotator cuff tear. You may also experience arm weakness while trying to perform your daily activities.

Worsening pain is an indication that the tear is getting bigger. It is important to speak with an orthopedic surgeon if you experience these symptoms or something similar. Your surgeon will want you to get an MRI or Magnetic Resonance Imaging to identify and confirm the injury.

You may be able to take care of your rotator cuff tear without undergoing any surgery if detected early. Nonsurgical treatment options may include cortisone injections, anti-inflammatory medicines, and physical therapy, among others.

Your surgeon may recommend you to schedule the surgery if the nonsurgical approach doesn’t yield required results. The goal of any shoulder specialist is to help you restore your strength while managing your pain.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Repairing Arthroscopic Rotator Cuff Tears

Arthroscopic rotator cuff repair is an advanced and revolutionary procedure for treating rotator cuff tears. This is a minimally invasive technique which can yield the same results as conventional rotator cuff repair procedures.

Arthroscopic rotator cuff repair or shoulder arthroscopy is a great way of treating tears in the rotator cuff. The entire shoulder joint can be evaluated by experienced surgeons. They use specially designed devices and instruments for fixing the tears using tiny incisions. Arthroscopic repair is particularly appropriate for large tears since it helps in visualizing and accessing the tear.

The following procedures are used to restore painless and normal motion:

  • Débridement: This is used in cases where the rotator cuff is loose and degenerated. The rotator cuff may have frayed tissue on the edges, which is removed to give healthy tissue access.
  • Mobilization: The rotator cuff is brought back to a normal position without putting undue tension. Margin convergence is used for larger tears.
  • Suture Anchors: Specially designed devices are used for fixing the tear in place to secure the bone to the cuff tear.

All-Arthroscopic Repair

Arthroscopic rotator cuff repair is of two types – all arthroscopic repair and mini-open arthroscopic repair. Arthroscope is used by the surgeon to look at the rotator cuff. It is a miniature camera which is guided after making a tiny incision on the effected joint. The camera will transfer images on a video monitor.

Mini-Open Arthroscopic Rotator Cuff Repair

This procedure makes use of a more advanced technology to repair the rotator cuff tear. The surgeon can directly view the tendons without using a screen or video monitor. It allows doctors to evaluate damage (if any) in the surrounding areas.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Bankart Repair

Bankart Repair Treatments

Bankart Repair in a minimally invasive procedure that will repair torn shoulder ligaments. Ligaments in the shoulder can tear when the shoulder dislocates or is bent out of place. The procedure makes use arthroscopy that helps in attaining faster, smoother and a less painful recovery.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Shoulder Anatomy

Shoulder is responsible for the most motion in the human body as compared to all other joints. It is a marvel of stability and mobility. The humeral head or shoulder ball remains centered in the glenoid (joint socket).

Glenoid is responsible for offering stability to your shoulder. The ligaments help in restraining the shoulder. They also help in making the shoulder more stable and keeping it from moving beyond its motion range. Concavity compression helps the rotator cuff to hold everything in place.

Understanding Bankart Repair

The ligament and glenoid tear when the arm is bent backward. This can cause the shoulder ball to dislocate from the joint socket. Bankart lesion is a common ligament injury. This is when the ligaments get torn from the socket.

The shoulder may lose stability if the glenoid and ligaments don’t heal properly. This is why repairing the tear is so important. This repair is popularly called Bankart Repair.

Symptoms of Bankart Repair

These are a few symptoms of Bankart Repair:

  • Unstable joint
  • Repeated dislocations
  • Catching feeling
  • Shoulder aches
  • Feeling that the shoulder may dislocate

Diagnosing Bankart Tear

Your physician will take a look at your medical history and symptoms to assess whether you have actually torn the ligaments in your shoulder. They will let you know if you require Bankart Repair. Your physician may also order scans and x-rays for determining if there is any loss of joint space.

Arthroscopic Bankart Repair Procedure

Arthroscopy is usually performed to repair a Bankart lesion. This is a minimally invasive procedure that involves making small incisions for inserting a probe-like camera. The camera allows the surgeon to examine the injured area completely before attempting to make any corrections.

The surgeon will use the same incisions to insert specialized instruments during an arthroscopy for making the necessary repairs. All tears in the tendon, muscle and cartilage will be fixed after removing the damaged tissue. The incisions will be stitched after the procedure.

Recovering From Arthroscopic Bankart Repair

Patients need to keep their shoulder and arm immobilized after Bankart repair. You would have to wear a sling for at least a month. Physical therapy generally starts from day 5 of the surgery. Physical therapy may be required for a period of 4 months following the surgery to strengthen your muscles and improve the range of motion.

You may not be allowed to participate in contact sports for at least six months following the surgery. Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Shoulder Socket Fracture (Glenoid Fracture)

Shoulder Socket Fracture Treatment

A shoulder fracture happens when the center or rim of the socket fractures. This can cause swelling, pain, bruising, and other similar symptoms. Generally, a shoulder fracture occurs due to high-energy impact, such as sports injury, falling from a height, or a car accident.

Typically, shoulder fractures are treated using surgical methods. This is because the fractured bone is dislocated and out of place. It needs to be correctly adjusted, which can only be done by way of surgery. The bone will heal incorrectly if it is not placed in the right manner. You may be left with permanent shoulder damage in this case.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Types of Shoulder Fracture

Shoulder fractures are not common injuries. They may happen because of significant injury to the shoulder, such as a car accident or a high fall. Glenoid fractures can be of two types:

  • Glenoid Fossa Fracture: Glenoid fossa is the central part of the socket. It is a far less common fracture and happens when the shoulder sustains extreme trauma. The glenoid fossa breaks in this type of fracture.
  • Glenoid Lip Fracture: This happens when the shoulder gets dislocated. The ball of the shoulder socket pushes against the socket rim, resulting in a clean break.

Symptoms of Shoulder Fracture

There are several types of symptoms accompanying shoulder socket fractures:

  • Swelling
  • Pain
  • Difficulty moving the shoulder
  • Bruising
  • Limited mobility in the shoulder
  • Grinding sensation when trying to move the shoulder

Nonsurgical Options for Shoulder Socket Fracture

Nonsurgical treatments generally get the job done when a shoulder socket fracture is not very severe. It will allow you to return to your every day chores. You would need to keep the shoulder in place with a splint, sling, or cast to ensure the bone heals as it should. Depending on the severity of the shoulder socket fracture, your shoulder may heal in a few weeks.

Bone stimulation is another process that helps in speeding up the healing process. The treatment uses low intensity pulsed ultrasound and low electric current. The body gets tricked into believing that there is an injury. It begins producing proteins essential for repairing cells in the injured shoulder.

Surgical Treatments for Shoulder Socket Fracture

The normal contour of the shoulder socket gets restored to prevent recurrent instability or dislocations of the shoulder joint. Often times, surgical treatments are considered for the injuries. This is especially true if the fracture consists of a large fragment of the bone or when the fracture is not aligned in position.

Shoulder socket fractures are highly uncommon, making it difficult to ascertain the ideal treatment. However, most surgeons believe that managing the fracture should depend on the patient’s needs and fracture type. You would be asked to undergo physical therapy as well when the fracture heals.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Shoulder Replacement

Shoulder Replacement Surgery

Thousands of traditional total shoulder replacements are carried out every year successfully in the US for patients suffering from shoulder arthritis. However, this type of surgery is not beneficial in patients with large rotator cuff tears, which have caused cuff tear arthropathy.

Conventional total shoulder replacement may not be able to alleviate the pain or increase motion for these patients. In fact, reverse total shoulder replacement is a far better option for these patients.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

How Does Reverse Total Shoulder Replacement Work?

Conventional shoulder replacement devices mimic your shoulder’s normal anatomy. In this type of surgery, a plastic cup like device is fitted to the glenoid or shoulder socket. A metal ball is then attached to the top of the humerus or upper arm bone.

Conversely, in reverse total shoulder replacement, the metal ball and socket are reversed. The plastic cup is fixed to the humerus while the metal ball is attached to the glenoid. This surgical procedure works better on patients with cuff tear arthropathy. This is because it makes use of different muscles for moving the arm.

Rotator cuff muscles in a healthy shoulder help power and position the arm for a wide range of motions. Rotator cuff muscles are used by conventional replacement devices to function properly. Patients with cuff tear arthropathy and large rotator cuff tear do not have these muscles in working order. Reverse total shoulder replacement relies on using the deltoids to position and power the arm instead of the rotator cuff.

Who is a Candidate for the Surgery?

Reverse total shoulder replacement surgery may be recommended in the following scenarios:

  • Cuff tear arthropathy
  • Irreparable or completely torn rotator cuff
  • Second surgery after an unsuccessful shoulder replacement surgery
  • Difficulty lifting the arm
  • Severe shoulder pain
  • Complex shoulder joint fracture
  • Chronic shoulder dislocation

What to Expect During the Pre-operative Stage?

You should wear button-front shirt and loose-fitting clothes on the day of the surgery when you go to the hospital. You may not be able to use your arm extensively since it would be placed in a sling after the surgery. You will be admitted on the surgery day and taken to the preoperative area. This is where you will meet with the anesthesiologist.

You will be given general anesthesia or a regional anesthesia depending on the operation. General anesthetic will help you sleep during the entire operation while regional anesthetic will numb the surgical area. You may be given a combination of the two as well.

Understanding the Surgical Procedure

Shoulder replacement procedure doesn’t take more than two hours. Your surgeon will make a small incision at the top or front of your shoulder and use it to remove the damaged bone. They will then reposition new components for restoring function.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Orthopedic & Sports Medicine Procedures: Revision Joint Replacement

Revision Joint Replacement

Most people who undergo a total knee replacement get back to an active life that is free from the debilitating chronic knee pain. However, in some rare cases, the procedure may fail to yield the expected results. In these types of situations, surgeons recommend a second surgery called a revision knee joint replacement.

The objective of a revision surgery is same as the primary total knee replacement. The technique, though, is more complex because the primary implant will have grown into the bone around the knee and has to be carefully removed. Besides, removal of this prosthesis means some part of the bone is also lost, leaving the surgeon with lesser bone to work on.

Revision knee replacement surgery therefore is a challenging procedure that requires specialized tools and implants along with more detailed planning for the procedure to succeed.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

How Does a Revision Surgery Work?

Revision knee replacement surgery can be of different types. In some patients, the surgeon will revise only one part of the prosthesis; in others, all the three parts – the tibial, femoral, and patellar components have to be replaced along with a rebuilding of the bone around the knee using augments or a bone graft.

If there is significant damage to the bone, the standard knee implants cannot be used for a revision surgery. In cases such as this, the surgeon will use special implants that come with a thicker and longer stem that can fit deeper into the bone to give extra stability and support.

Procedure of Revision Knee Replacement

Revision knee replacement surgery is a very challenging and complex process and may take about 2 to 3 hours time to complete.

The surgeon will first make an incision along the older incision from the primary total knee replacement surgery. The new incision may extend farther in order to allow removal of the old components.

The surgeon then moves in to place the tendons and kneecap aside and reveals the knee joint. They will look for signs of infection in the soft tissues around the knee, and also examine the plastic and metal parts of the prosthesis to check which part has grown loose or worn out or moved out of its intended position.

Any cement that was used in the primary surgery is removed and retaining as much bone as possible, the surgeon will remove the original implant. Next, they will prepare the bone surface to receive the revision implant. Any deficit in the bone around the knee is made up using platform blocks and augments.

In some rare cases, bone grafts may be required to rebuild the knee, and they may be sourced from your own bone or from some donor. Once the bone is adequately prepared, the surgeon inserts the revision implant and any damage to the surrounding soft tissue is repaired before carefully testing the new joint’s movement.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Orthopedic & Sports Medicine Procedures: Hip Replacement

Hip Replacement

Hip replacement surgery is recommended for patients with painful arthritis in the hip joint. In this procedure, the surgeon removes the affected joint and replaces it with a prosthetic one made from plastic and metal components. A successful hip replacement surgery gives the patient relief from pain in the hip and makes walking easier.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Direct Superior Hip Replacement Technique

Total joint replacement surgery is a field with new technologies evolving at a steady pace. In the field of hip replacement surgery, the latest surgical technique which is minimally invasive is called the Direct Superior Approach.

This newer technique of hip replacement uses an antero-lateral hip approach which is a modified form of the older anterior and posterior techniques. The surgeon makes a single incision in the region near the buttock and works around the muscles surrounding the hip joint.

This results in minimal trauma to the soft tissue in the area. Once the implant is in position, the surgeon repairs the capsule of the hip and the skin to prevent the hip from dislocating, and allow it to heal.

In this approach, the hip does not have to undergo the classical dislocation. This means there is minimal stretching of the capsule, tendons and muscles while removing the femoral head of the joint. As a result, there is less bleeding and also, even less pain than in the other surgical techniques of hip replacement.

Also, because the attachments of the anterior and posterior capsule to the femur are unaffected, the hip stays as perfectly stable as possible. Only one deep muscle structure called the piriformis tendon has to be released during this direct superior technique, and it is easy to repair during the closure.

Patient Benefits From Direct Superior Approach

When a surgeon uses the direct superior approach for hip replacement, it has distinct advantages for the patient such as:

  • Smaller size of incision
  • Lesser damage to the tendon and muscle
  • Decreased blood loss
  • Lower rates of dislocation
  • Lesser possibility of extremity twisting because leg stays in a near-natural position during the surgery
  • Fewer precautions required post-surgery
  • Lower level of pain post-surgery, resulting in reduced usage of pain medication; pain may respond well to mere over-the-counter medication, too
  • Earlier discharge after surgery, even on post-operative first day
  • Lower risk of complication

Precautions to Take Post- Hip Replacement Surgery

Before you are discharged from the hospital, your surgeon will provide you with instructions to make your life easier post-hip replacement surgery. These may include the following:

  • Sit upright in a straight-back, firm chair and do not use recliners.
  • To avoid bending too far and putting pressure on the hips, use a raised toilet seat.
  • Avoid climbing stairs.
  • Keep the floor free of clutter to reduce the possibility of a fall.
  • Refrain from strenuous activities such as physical exercise, driving and sexual activity until your doctor gives you the go-ahead.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

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702.933.9393
9499 West Charleston, Suite 200
Las Vegas, NV 89117