Introduction

The shoulder, which joins the arm to the torso, is a complicated joint composed of several joints and tissue layers that allow an unusually large range of motion. This is only possible at the expense of stability in that the joint is controlled by loose ligaments and strong musculature instead of bony parts and tight ligaments. It is therefore not surprising that a large proportion of the diseases of the shoulder occur in the soft tissues, while arthritis, which predominates in the hip and knee, is less frequent.

Shoulder pain without a clearly definable cause is very common. These complaints arise mainly from the so-called rotator cuff, a tendinous hood that surrounds the shoulder head on three sides. All sort of damages may develop in these tendons, from irritation and inflammation, via partial tears, to complete, and occasionally extensive, defects. Sometimes calcium deposits in the rotator cuff tendons are the source of shoulder pain. Not infrequently, the shoulder becomes painfully stiff following a trivial injury, or even without obvious cause. At worst, many patients are disturbed by tiresome and fatiguing night pains, which are typical for diseases of the shoulder soft tissues.

Additionally, injury to the shoulder commonly results from accidents due to work or leisure activities. Depending on the mechanism of the accident, a fall can cause the dislocation of the acromioclavicular joint, of the shoulder (glenohumeral) joint, or tears in the rotator cuff. Fractures are not uncommonly found, particularly among older people.

The doctor has to decide which injuries are best managed surgically, and which non-surgically (i.e. conservatively). Often an operation is only necessary once the correctly followed conservative treatment has failed. This is the point at which your general practitioner should refer you to a specialist.

For the diagnosis of shoulder problems magnetic resonance imaging (MRI) is now firmly established (in addition to the essential X-ray) because the soft tissues can be clearly visualised. Our understanding of shoulder damage has increased rapidly in recent years. For-tunately, we now have surgical treatment options, which are more successful and less harmful to patients than previously.

Arthroscopy, a so-called minimally invasive procedure, has resulted in great progress, and the majority of shoulder interventions can now be performed arthroscopically. For the patient this means less pain, smaller scars and faster healing.

With the surgical procedures in use today, good results are achieved in the vast majority of cases. The importance of correct postoperative treatment with suitable physiotherapy, which may last months, cannot be overestimated. The appropriately instructed patient can, and should, carry out most of the exercises at home him/herself.

In our specialized department, we are in a position to cover the entire spectrum of tried-and-tested and innovative shoulder surgeries. The doctors, nursing team and physiotherapists will give their best to ensure the operation is successful and that your stay is as comfortable as possible (and as short as necessary). We welcome your suggestions and criticisms, while appreciation and praise are not forbidden!