Shoulder

Dr Gavin Nimon as head of Shoulder Surgery at the Queen Elizabeth Hospital has extensive experience in the treatment of shoulder conditions. Comprising of 3 joints ( Gleno-humeral, Acromio-clavicular and Sterno-Clavicular joints) and 3 main bones (Scapula, Proximal Humerus and Clavicle) the shoulder has many moving parts with many possible causes of pain, stiffness and other symptoms. Dr Gavin Nimon as head of Shoulder Surgery at the Queen Elizabeth Hospital has extensive experience in the treatment of such conditions.

A good way of thinking of shoulder conditions is to divide them up into traumatic injuries ( Breaks, Dislocations and Infections) or elective conditions.

The most common elective conditions are those that involve the rotator cuff. While traditionally this predominantly involves bursitis and tendinopathy ( with minor partial tears of the rotator cuff) progressing to full rotator cuff tears,  Dr Nimon likes to consider labral tears and bicep injuries in this group as well as AC joint arthritis.

This is because these injuries can look similar with pain on motion, as well as the fact that these conditions are treated with an arthroscopy ( key hole or minimlally invasive surgery).

Arthitis is a relatively common cause of shoulder pain and is often associated with reduced motion (stiffness). There are 2 main types, primary- which can be treated with an anatomical shoulder replacement, or rotator cuff arthropathy (where there is a large tear of the rotator cuff leading to arthritis) and this is treated with a reverse total shoulder replacement.

The final common cause of shoulder pain and stiffness is frozen shoulder, which can lead to severe pain but is often self limiting.

Referred pain from the neck is always a trap for the assessor, as this can cause shoulder pain but is actually arising from neck issues. Dr Nimon is always vigilant for this, and often will start by checking the neck in his assessment. 

 

 

The shoulder

What Shoulder Surgery Can Be Done ?

Photo in surgery

At Glenelg Orthopaedics we have over 21 years of experience with shoulder surgery and offer shoulder reconstruction procedures which in 95% of the cases are undertaken through a totally arthroscopic approach (keyhole).

This involves the use of several 1 centimetre incisions around the shoulder through which we can then undertake:

    • An arthroscopic decompression
    • An acromioclavicular ( AC joint ) excision
    • A rotator cuff repair
    • Arthroscopic bursectomy
    • Biceps tenodesis or release (tenotomy)
    • Stabilisation procedures.
    • These procedures can be undertaken totally arthroscopically as opposed to an arthroscopy to assess the shoulder and then a mini-open approach.

A totally arthroscopic approach leads to less pain and also protects the deltoid muscle surrounding the shoulder..

Arthroscopic surgery involves an overnight stay in hospital and the procedure can be undertaken at Glenelg Community Hospital, Flinder Private Hospital or Ashford Hospital..

We also perform Total Shoulder Replacements, both anatomic (conventional) or reverse.

We have extensive experience with these procedures and perform them regularly at Ashford, Flinders Private Hospital or Glenelg Community Hospitals. It is undertaken for arthritis of the shoulder, rotator cuff tears that rea irrep[airable or for fractures, and as the lead shoulder clinician at the Queen Elizabeth Hospital, Dr Nimon performs a large number both in private and public hospitals each year.

Breaks and Dislocations

Injuries to Shoulders are very common, particularly in sports: Injuries include:

Rotator Cuff

The Rotator Cuff comprises the 4 muscles that encircle the shoulder under the deltoid, joined by the long head of biceps tendon which attaches to the labrum. Issues can occur with any of these:

Arthritis

Arthritis can affect any part of the body and the Shoulder is no exception. Shoulder replacements are a very common procedure undertaken by Dr Gavin Nimon. There are 2 main types: Anatomic and Reverse.

Frozen Shoulder

A common cause of pain with developing stiffness id frozen shoulder. Morde commonly associated with diabetes, it can occur in anyone.

Referred Pain from Neck

Often a surprise to the patient, not all shoulder pain comes from the shoulder. Referred pain from the neck is not common, and Dr Nimon is always vigilant to exclude this as a cause.

Can Rotator Cuff tears be repaired key-hole?

A common question asked to Dr Nimon is “Can a tear of the rotator cuff be repaird arthroscopically?” The answer is yes. Dr Nimon has extensive experience in this and has trained many of the othert doctors in Adelaide.

Common Questions after Surgery

There are many questions that may arise after surgery. Some of these are:-

Post-Operatve Information

Can’t find that information sheet Dr Nimon gave you on discharge, Here are copies for you:-