Preface

**Section 3 Reconstruction 125**

**VI** Contents

E. Rosen

**Cuff Tears 127**

**Section 4 Rehab and Miscellaneous 153**

**Disorders 207**

José Miguel Esparza Miñana

Palermo and Rosa Grazia Bellomo

Chapter 7 **Superior Capsule Reconstruction: Review of a Novel Operative Technique for Management of Irreparable Rotator**

Chapter 8 **Integral Management in Painful Shoulder Treatment: Anesthesiologist's Point of View 155**

Chapter 9 **The Rheumatoid Shoulder: Current Surgical Treatments 169**

Chapter 10 **The Role of Physical Medicine and Rehabilitation in Shoulder**

Alexander Golant, Daiji Kano, Tony Quach, Kevin Jiang and Jeffrey

Nuri Aydin, Lercan Aslan, Janne Lehtinen and Vedat Hamuryudan

Raoul Saggini, Simona Maria Carmignano, Lucia Cosenza, Tommaso

*Advances in Shoulder Surgery* is a book aimed at providing readers the perspective of some of the shoulder disorders. In day-to-day practice, we face dilemma in treating some really difficult shoulder patients. In this book, we tried to answer some of these issues. We have included some of the least-discussed topics like surgical management in rheumatoid arthritis (RA) pa‐ tients, superior capsular reconstruction (SCR), detailed physiotherapy and rehab. The main motive of this book is to answer some of the management problems in some shoulder disor‐ ders.

For the convenience of the readers, we have divided the book into four sections to highlight each and every aspect in detail.

The section 'Repair' deals with massive rotator cuff injuries, subscapularis repairs, etc.; the section 'Replacement' highlights the finer aspects of total shoulder replacement and reverse shoulder replacement in different settings; the section 'Reconstruction' provides perspec‐ tives on the indications and techniques of SCR; and lastly the section 'Rehab and Miscellane‐ ous' deals with rheumatoid arthritis of the shoulder and also rehab. Each chapter is written by a recognized expert in the field whose experience will help readers understand the nuan‐ ces of diagnosing and treating the said shoulder disorder in a proper way.

Each chapter includes:


*Advances in Shoulder Surgery* has gone through a thorough scrutiny, and every chapter pro‐ vides even its most experienced reader with new knowledge and technical pearls, which will benefit both the surgeon and the patient.

Finally, we hope this book will be of great help and benefit to the readers and in the devel‐ opment of shoulder surgeries.

> **Dr. Satish B. Sonar,** Dr. PDM Medical College Amravati, Maharashtra, India

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: Shoulder Joint**

**Introductory Chapter: Shoulder Joint**

DOI: 10.5772/intechopen.76187

The shoulder is a ball and socket type of synovial joint. It is one of the largest and most complex joints in the body. Its dynamic and hypermobility make it susceptible to many

The shoulder girdle comprises of glenohumeral joint, acromioclavicular joint, scapulothoracic

Deltoid, one of the strongest muscles in the body, encircles the shoulder joint all around. It provides the shape and bulk to the shoulder joint. It works in almost all the functions of the joint from forward flexion, abduction, and adduction to rotations. It is supplied by the axillary nerve. The pectoralis major and minor, rhomboids, latissimus dorsi, teres major, and trapezius are other major muscles that play an important part in the function and stability of

Rotator cuff provides concentric compression, dynamic stability, and smooth arc of motion to the glenohumeral joint. The subscapularis along with the anterior part of the supraspinatus provides excellent anterior stability. The posterior part of the supraspinatus, infraspinatus, and teres minor provides posterosuperior stability and resists superior pull of deltoid. In addition to the glenoid labrum, rotator cuff muscles are the dynamic stabilizers of the shoulder joint. Injury, dysfunction, or degenerative tears of these muscles hampers the shoulder

The subdeltoid bursa cushions and protects the tendons of the rotator cuff. It also provides nutrition and lubrication to the rotator cuff tendons. The subacromial bursa can get inflamed in impingement syndrome, RA, calcific tendinitis, and other subacromial painful pathologies

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

Satish B. Sonar and Omkar P. Kulkarni

articulation, and coracoclavicular articulation.

causing severe pain and movement restrictions [1].

Satish B. Sonar and Omkar P. Kulkarni

http://dx.doi.org/10.5772/intechopen.76187

**1. Basic shoulder anatomy**

shoulder girdle (**Figure 1**).

function to a great extent.

injuries.

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

#### **Introductory Chapter: Shoulder Joint Introductory Chapter: Shoulder Joint**

Satish B. Sonar and Omkar P. Kulkarni Satish B. Sonar and Omkar P. Kulkarni

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.76187
