Shoulder Surgery: Why Choosing the Best Surgeon and Technology Matters

Having shoulder surgery can be a daunting prospect that may cause considerable concern. There's the anesthesia, complexity of surgery, post-operative pain and the journey of rehabilitation after your operation. This results in many unknowns, but being aware of what to expect and understanding the process beforehand will lead to a smooth postoperative recovery. Most important is feeling at ease that you're in good hands.

In general, there are three broad categories of shoulder procedures: arthroscopic procedures like rotator cuff repair and labral repair that address soft tissue problems; reconstructive procedures such as shoulder replacements and tendon transfers; and fracture fixation procedures, which include fixing humerus, glenoid, clavicle and scapula fractures.

For each category, the physicians in our orthopedic department have extensive experience employing the most current techniques. For every procedure, they use minimally invasive techniques to achieve the best outcome with the lowest risk of complications or adverse events.

According to Paul Favorito, MD, our division chief of shoulder and upper extremity services, the first critical step is to identify a physician experienced with treating shoulder disorders who will make a correct diagnosis. "Although that seems obvious, it's not always easy," he said. "The shoulder is a complex joint. Shoulder symptoms may originate from other locations such as the neck or heart. If so, treating the shoulder will not resolve symptoms."

Favorito has a 19-year history of being a leader in shoulder care. For example, he has performed the most arthroscopic cases in the United States of a procedure designed to manage recurrent shoulder dislocations. Traditionally, that procedure has been performed with open surgery. The arthroscopic procedure allows patients to have less postoperative pain, use fewer narcotics, rehabilitate faster and return sooner to work and sports. For humeral fractures, he uses cutting-edge products, some that he has helped design. For shoulder replacements, he uses an advanced 3D imaging software program to plan cases preoperatively and assist intraoperatively with implant positioning. These are three examples of many, and Favorito links his success to his experience and the technology we have available at The Christ Hospital.

Marc Schneider, MD, orthopedic surgeon and sports medicine specialist, is the first surgeon to bring shoulder GPS technology to the tristate region. This is a computer-based system which combines preoperative 3D imaging with intraoperative tracking devices to produce real-time digital images during anatomic and reverse shoulder replacement surgery. According to Dr. Schneider, "surgery is a combination of art and science" and with over 20 years of experience he believes "the live visual guidance provided by the GPS system is a major breakthrough in shoulder surgery. By improving the accuracy and precision of surgery, patients have better clinical outcomes and can return to enjoying their lives sooner."

Additionally, Dr. Schneider believes in the "perioperative team" approach to the care of his patients, working closely with top notch anesthesiologists, medical assistants, nurses, athletic trainers and physical therapists to allow for an enhanced and quicker recovery. Improvements in pain management such as periarticular nerve blocks, longer lasting local anesthetics, and cryoanalgesia are just some of the newer techniques that are utilized by our physicians to decrease postoperative pain. In addition to the GPS system, Dr. Schneider performs advanced arthroscopic procedures such as complex rotator cuff repairs, superior capsular reconstruction and cartilage regeneration surgery. Our team is passionate in ensuring patients have the best experience possible, with or without surgery.

Being in the right hands, with the right technology, is key. But Favorito and Schneider said there are a number of things patients should know about shoulder injuries and issues that can help with the recovery process: 

  • Avoid surgery if you can. Most shoulder problems can be treated nonoperatively. If a brief period (5-7 days) of activity modification like rest and over-the-counter medications do not improve symptoms, consider evaluation by an experienced physician.

  • Know when you need an expert's opinion. Symptoms that require more immediate evaluation by a physician include:

    • An injury that causes deformity, swelling or bruising around the shoulder.

    • Shoulder pain that persists while resting or that awakens you at night.

    • Inability to carry objects or raise the arm or elbow away from the body.

    • A feeling like the shoulder is dislocating or popping out of place.

    • Any sign of an infection, including open wounds, fever, excessive warmth or redness.

  • If surgery is chosen, ask your surgeon about the number of procedures performed and their results. Ask to speak with one of their patients who has had a similar procedure.

  • Understand the plan for pain management. The opioid epidemic is a real concern. A recent study demonstrated that 8% of patients undergoing arthroscopic shoulder surgery will continue to use opioids well after the procedure.

  • Make sure your surgeon is aligned with the anesthesiologist to control pain during the surgery. Using different medications and techniques, also known as a multimodal approach, will improve the recovery experience.

  • Know how to make your recovery at home easier:

    • Button-down shirts and slip-on shoes make it much less challenging to get dressed after shoulder surgery.

    • Sleeping propped up with a large reading pillow or in a recliner may make it much easier to get comfortable at night.

    • Most shoulder surgeries require the use of a sling for at least some period of time. You will typically be able to use your hand for light activities like keyboarding or operating a mobile phone but discuss this with your surgeon immediately after the procedure.

Our fellowship-trained shoulder surgeons utilize the most advanced arthroscopic and open surgical techniques available. In addition to Dr. Favorito and Dr. Schneider, our comprehensive surgical shoulder care team includes Jacob Gunzenhaeuser, MD; Robert Jolson, MD; Edward Lim, MD; and Michael Palmer, MD.

No matter what kind of shoulder pain you have, we have an expert who can help. Call 513-818-4433 today or click for more information or to schedule an appointment online.