The Shoulder Joint – the Evolution of Shoulder Orthopedics

From a biomechanical standpoint, the shoulder region - with its complex interplay of no fewer than five joints - is dominated by the glenohumeral joint. Owing to the disproportion between the large humeral head and the small saucer-shaped glenoid socket, the loading stability of this joint requires a balanced interaction of the ligaments and muscles.
The special anatomical and biomechanical features of the shoulder explain its special relevance for sport orthopedics.

Sport injuries and sport damage to the shoulder account for approx. 30% of our patient population and are thus very important. Prompt treatment of shoulder disorders based on the pathology in the individual case is thus of outstanding prognostic value for the preservation of shoulder joint function.

Joint MRI has proven to be a valuable diagnostic procedure here and enables sport orthopedics to use invasive procedures in a carefully selected group of patients with shoulder pathology. Minimally invasive techniques, in particular, have left their stamp on the development of shoulder orthopedics. Another significant advance was the development of bioabsorbable and biocompatible materials used, in particular, for shoulder surgery.

For example, about 80% of shoulder operations performed today are carried out with arthroscopic or percutaneous techniques. The large expenditures for surgical equipment are justified by the improved treatment results, shorter hospitalization times, quicker return to the job, and lower rate of complications.

It is necessary to use two image intensifiers, for example, to visualize a subcapital multi-fragment humeral head fracture in two levels during surgery. The titanium helix wire inserted percutaneously can be positioned precisely and without complications, for example, so that the patient can achieve early functional rehabilitation with little pain.

However, these diagnostic and therapeutic advances require a maximum of special know-how. In the future as well, this kind of know-how will be found only at specialized centers.