The shoulder is the most flexible ed instable human joint, based on a complex balance between different bones, tendons, muscles and ligaments; the key to treat successfully shoulder disorders is to make a correct diagnosis. That’s why some orthopaedic surgeons, like Dr. Lisai do, decide to dedicate, study, treat and operate exclusively this joint.

Since more than 10 years, Dr. Lisai focused his activity in mini-invasive shoulder surgery (he performed more than 1500 shoulder operations) for rotator cuff, glenohumeral instability treatment and osteoarthritis with a very great satisfaction for the patients: arthroscopic techniques allow to lesser invasivity, maximum respect of muscular tissues, faster rehabilitation and better aesthetic results.

The majority of patients with shoulder pain have a rotator cuff tear: it determines night pain and weakness; the diagnostic can be done with a clinical examination, shoulder x-ray and MRI.

Recently, for the treatment of this pathology, Dr. Lisai started using new arthroscopic devices with no metal implants lefts in the shoulder; this technique is known as “transosseous arthroscopic anchor-less repair of rotator cuff tears”: the broken tendon, normally the supraspinatus, is fixed to the bone with many sutures passing through the bone, performed with a specifically designed arthroscopic device; in this way, there is no need to implant metal anchors, like in the past, avoiding its mobilization as major complication.

As a final result, the transosseous tendon repair is stronger, the bone-to-tendon contact surface is larger and the post-operative pain is less.

At the same manner, shoulder instability is a big problem, especially for young and sports people: after many traumatic episodes, this articulation can dislocate sometimes with minimally efforts or during the rest!

Shoulder X-ray, MRI arthrogram and 3D-CT scan can help the surgeon to choose the best operation.

Regarding instability arthroscopic surgery, namely capsuloligamentous plastic and repair, Dr. Lisai uses soft anchors, instead metal anchors, in order to avoid any cartilage damage; at the same time, for importants glenohumeral instabilities, he is very confident in the traditional open technique known as Latarjet procedure.

All arthroscopic procedures are performed on loco-regional anesthesia with an hospitalization of 24 hours. After 4 weeks of partial immobilization, the patients is followed by a physiotherapist in order to optimize the functional recovery. Sports and heavy works activities could be started after 3 months.

Shoulder osteoarthritis affects especially people over 60-65 and is characterized by constant pain and progressive joint stiffness: patient is unable to comb, to put a shirt,…

In the early stages of this pathologies patients can benefit from conservative treatment as intra-articular hyaluronic acid injections under x-ray guidance: we can dispose of different molecular weight hyaluronic acids to use in depending from the cartilage damage; Dr. Lisai may decides on the basis of a clinical examination, shoulder x-ray and MRI.

Also about arthritis surgery, Dr. Lisai pays attention to new prosthetic models, increasingly smaller and reliables: the operation is performed on general anesthesia and the hospitalization period is 2-3 days. After 3 weeks of partial immobilization, the patient starts the rehabilitation and after 2 month his quality of life will be significantly improved than before the surgery.

 

Dr. Andrea Lisai is an orthopaedic surgeon specialized in arthroscopic and prosthetic shoulder surgery.