Shoulder Preservation Surgery: Protecting Your Joint Before Replacement Becomes Necessary
By Dr. Phillip Sussman, DO – CMC Orthopaedics
Fellowship trained in Orthopedic Sports Medicine at Orlando Regional Medical Center
Does reaching for items on high shelves cause you pain? Have you modified your favorite activities because of shoulder discomfort? As an orthopedic surgeon specializing in sports medicine, I see patients with these challenges every day. If shoulder problems are affecting your quality of life but you’re hesitant about major surgery, I want you to know that shoulder preservation surgery might be the solution you’re looking for. Let me tell you how we are helping people just like you at CMC Orthopaedics.
Understanding Your Shoulder: A Remarkable Machine
When I talk with my patients, I often describe the shoulder as a sophisticated machine with many moving parts working together. Like any well-used machine, these parts can wear down or become damaged over time. Your shoulder is actually the most mobile joint in your body—capable of reaching over your head, behind your back, and across your body—but this impressive mobility comes at a cost: vulnerability to injury.
I find that many of my patients understand the concept better when I explain that the shoulder is like a golf ball (the head of your upper arm bone) sitting on a tee (the shallow socket of your shoulder blade). This design gives you amazing range of motion but relies heavily on muscles, tendons, and ligaments to keep everything stable and functioning properly. In my practice, I see the consequences of this delicate balance every day.
What is Shoulder Preservation Surgery?
Shoulder preservation surgery encompasses any procedure aimed at maintaining the natural structure and function of your shoulder joint. Think of it as restoration work on a historic building—addressing specific problems while preserving the original architecture—rather than demolishing and rebuilding from scratch (which would be similar to total shoulder replacement).
These procedures are less invasive than joint replacement and are designed to delay or even eliminate the need for more extensive surgery down the road.
When Might You Need Shoulder Preservation Surgery?
You might be a candidate for shoulder preservation if you have:
- Rotator cuff tears: Imagine the rotator cuff as the suspension system that stabilizes the golf ball on the tee. When these crucial tendons tear, the shoulder’s stability and function become compromised.
- Shoulder dislocation: This occurs when the ball completely comes off the tee, potentially damaging the rim of the socket or other structures.
- Mild-to-moderate arthritis: The protective cartilage coating your joint surfaces has begun to wear away, like brake pads wearing thin on a car.
- Degenerative joint conditions: Various conditions can cause the joint to deteriorate over time, similar to parts wearing out in an aging machine.
Typically, we recommend shoulder preservation surgery when non-surgical treatments like physical therapy, medication, or injections haven’t provided adequate relief.
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Common Shoulder Preservation Procedures
In my surgical practice, I perform most shoulder preservation surgeries arthroscopically—using tiny instruments inserted through small “keyhole” incisions. I often tell my patients to think of arthroscopy as similar to using a small inspection camera to find and fix problems inside your home’s walls without tearing down the entire wall. This minimally invasive approach allows me to address the problem while minimizing trauma to surrounding tissues.
Two common procedures I perform include:
Debridement with Capsular Release
Imagine your garden after a storm—there might be broken branches and debris scattered about, and some plants might be tangled or constricted. Debridement is like cleaning up this garden:
- We remove loose cartilage fragments (the debris)
- We trim inflamed tissue that’s causing pain
- We release tight tissue that’s restricting movement (the capsular release)
This procedure works particularly well for patients with mild arthritis who experience catching sensations and stiffness in their shoulder.
Microfracture
Picture a garden bed where plants aren’t growing well. A gardener might aerate the soil to allow more nutrients to reach the roots. Microfracture works similarly:
- We make tiny holes in the bone beneath damaged cartilage
- These holes allow healing elements from your bone marrow to reach the surface
- These elements form a new cartilage-like surface in the damaged area
Benefits Over Total Shoulder Replacement
Shoulder preservation offers several advantages:
- Maintains your natural anatomy
- Less invasive with smaller incisions
- Shorter recovery time in most cases
- Preserves future options if more treatment is needed later
- Delays or possibly eliminates the need for shoulder replacement
Potential Risks
While shoulder preservation surgery is generally safe, all surgeries carry some risks, including:
- Infection (rare with arthroscopic procedures)
- Bleeding
- Delayed healing
- In some cases, incomplete resolution of symptoms
Is Shoulder Preservation Right for You?
When I evaluate patients in my office, I look for several factors to determine if they’re good candidates for shoulder preservation surgery. The ideal candidate typically:
- Has specific, identifiable shoulder problems
- Has not found relief with non-surgical treatments
- Is motivated to participate in rehabilitation
- Does not have advanced joint destruction
Every shoulder is unique, just as every patient has individual needs and goals. During our consultation, I’ll take time to thoroughly evaluate your condition, listen to your concerns, and discuss all appropriate options. I’ve found that this personalized approach leads to the best outcomes for my patients. Many times, I can identify subtle issues that have been overlooked but are actually the main source of pain.
Take the Next Step Toward Shoulder Health
If shoulder pain is limiting your activities or affecting your quality of life, I encourage you to schedule a consultation with me at CMC Orthopaedics. When I work with patients, my goal is always to get them back to the activities they love with minimal downtime. Together, we can determine whether shoulder preservation surgery might help you return to an active lifestyle with less pain and better function.
Throughout my fellowship training and years in practice, I’ve developed specialized techniques that have helped many patients avoid or delay major shoulder replacement. I believe strongly in exploring less invasive options first whenever possible, and I’ll work closely with you to develop a treatment plan that meets your specific needs.
Don’t let shoulder pain keep you from the activities you love. I’ve helped countless patients regain their shoulder function, and I would be honored to help you too. Contact CMC Orthopaedics today at 843-347-8041 to schedule an appointment with me.
Dr. Phillip Sussman, DO
CMC Orthopaedics
Dr. Sussman completed his undergraduate education at the University of Florida, where he received a bachelor’s degree in Biology. He then earned his Doctor of Osteopathic Medicine degree from Lake Erie College of Osteopathic Medicine in Bradenton, FL. Following medical school, Dr. Sussman completed his orthopedic surgery residency at HCA Florida Healthcare/USF Morsani College of Medicine in Largo, FL. He then completed his sports medicine fellowship at Orlando Regional Medical Center.
