Arthroscopic and technological advances have significantly improved our ability to treat many disorders of the shoulder. Arthroscopic and "mini-open" rotator cuff repair techniques can repair and reconstruct major rotator cuff injuries. Without having to detach (and subsequently repair) any normal muscle attachments during surgery, the postoperative recovery is significantly improved, and the surgery can often be done as an outpatient. Shoulder instability is another condition that provides a classic example of how far we have come and the direction we are headed.

Case One
In this typical case, a 23-year-old gentleman had recurrent left shoulder dislocations. This caused him to be constantly on guard against certain shoulder movements that would cause the shoulder to slip out of joint. Despite this constant vigilance, he continued to have dislocations requiring visits to the Emergency Room. Interestingly, he had recently been treated for an identical problem on the right. This had been addressed by a typical open technique by his previous Sports Medicine Physician. While this approach has a high success rate in terms of recurrent dislocation, it is associated with a much lower return to sports in overhead athletes. In addition, it requires substantial more trauma to the musculature, results in more scarring and can have quite a prolonged, painful recovery.

By chance, this particular gentleman learned of the successful result of an exceptional athlete treated by Dr. Lurate with minimally invasive arthroscopic technique. Keenly aware of the recent experience with his right side, he elected to go with the arthroscopic technique. As you can see from the pictures two weeks out from surgery, the difference in outside scarring is impressive. In the words of the patient, there was a "night and day difference" in his postoperative recovery. For general information on shoulder instability click here.

Case Two
This 18-year-old, right hand-dominant construction worker broke his right forearm in a fall. Most patients with this injury would be treated with a large plate and screws placed through a lengthy and unsightly incision in the forearm. Instead, this gentleman was treated with a Rush rod placed through a tiny incision near the wrist. Rush rods were invented in the early part of the last century by Dr. Rush from Meridian, Mississippi. The seemingly simple technique actually is quite difficult to master and consequently has never gained widespread popularity. However, as many orthopaedic surgeons can attest, by preserving the fracture hematoma (initial bone marrow bleeding) and not violating the soft tissue/periosteum envelope, fractures such as this will actually heal quicker. This gentleman quickly healed and returned to work with an excellent functional and cosmetic result.