01 — SCOPE
Shoulder Surgery at the NefroCenter Group’s Center for Complex Orthopedic Surgery
Shoulder surgery is a specialist answer to the conditions that compromise movement, stability and quality of life: rotator cuff tears, recurrent dislocations, osteoarthritis, stiffness, instability and complex trauma. The Center for Complex Orthopedic Surgery of the NefroCenter Group is at the cutting edge and also deals with operations that elsewhere have not produced the hoped-for results. In fact, the patient is accompanied along a complete pathway, from diagnosis to rehabilitation, with a highly specialized orthopedic approach.
The goal is not only to treat the pain, but to recover function, independence and confidence in everyday movements. This is why the assessment of the shoulder requires specific expertise, advanced diagnostic technologies and a personalized treatment strategy.
Prof. Raffaele Russo is a national reference specialist for shoulder and elbow surgery, with consolidated experience in the treatment of complex joint conditions.
How the shoulder works and why it can be injured
The shoulder is one of the most mobile joints in the human body. This great freedom of movement makes it possible to lift the arm, rotate it, bring it above the head and perform complex gestures, from sports to daily activities.
From an anatomical point of view, the shoulder is not made up of a single joint, but of an integrated system that includes the glenohumeral joint, the acromioclavicular joint, the sternoclavicular joint and scapulothoracic movement.
A fundamental role is played by the rotator cuff, a group of muscles and tendons formed by the supraspinatus, infraspinatus, teres minor and subscapularis. These structures stabilize the head of the humerus and allow precise movements.
It is precisely its great mobility that makes the shoulder more exposed to injuries, instability and degeneration. Trauma, wear, repetitive work activities, sports, age and individual predisposition can alter the balance of the joint and cause pain, stiffness or loss of strength.
02 — SERVICES
The main conditions treated in Shoulder Surgery
Rotator cuff tears
A rotator cuff tear is one of the most frequent causes of shoulder pain in adults. It can result from trauma, progressive wear or tendon degeneration. The most common symptoms are night pain, difficulty lifting the arm and loss of strength. When conservative treatment is not enough, surgery may be indicated.
Shoulder instability and recurrent dislocation
Instability occurs when the head of the humerus tends to come out of its natural seat. It can appear after a traumatic dislocation or in predisposed individuals. In recurrent cases, especially in young patients or athletes, surgery may be necessary to stabilize the joint and reduce the risk of further dislocations. Find out how we treat shoulder instability.
Shoulder osteoarthritis and glenohumeral arthropathy
Shoulder osteoarthritis is a degenerative condition that progressively wears away the joint cartilage. It causes pain, stiffness and limited movement. In advanced cases, when medicines, injections and physical therapy no longer allow adequate control of symptoms, shoulder replacement may be indicated. Shoulder replacement: techniques and indications.
Subacromial impingement
Subacromial impingement is a condition in which the rotator cuff tendons are compressed during movement. It can cause pain when lifting the arm and functional limitation. In the early stages it is often treated with physical therapy and medical treatment, but in resistant cases a surgical solution may be considered.
Calcific tendinopathy of the cuff
Calcific tendinopathy is characterized by the presence of calcium deposits in the rotator cuff tendons. It can cause intense, sudden pain or chronic symptoms. Treatment depends on the size of the calcification, the pain and the response to conservative treatments.
Adhesive capsulitis or frozen shoulder
Adhesive capsulitis causes progressive stiffness of the shoulder and significant limitation of movement. It often evolves slowly and can make simple gestures such as dressing or combing one’s hair difficult. Treatment is generally rehabilitative, but in the most complex cases targeted specialist treatments may be necessary.
Injuries of the long head of the biceps
The long head of the biceps can suffer inflammation, instability or rupture. The pain is often located in the front of the shoulder and can be associated with cuff tears. Surgical treatment is considered when the pain persists or when the injury compromises function.
Multidirectional instability
Multidirectional instability affects patients in whom the shoulder is unstable in several directions. It is often linked to capsuloligamentous laxity and requires a very careful assessment. Surgery is considered in cases where the rehabilitation pathway does not guarantee sufficient stability.
Post-traumatic stiffness
After fractures, dislocations or surgery, the shoulder can lose mobility. Post-traumatic stiffness requires a structured rehabilitation pathway and, in some selected cases, surgical procedures to recover movement and function.
The surgical techniques used
Shoulder surgery includes different techniques, chosen according to the condition, the patient’s age, the level of activity and the quality of the tissues.
Shoulder arthroscopy is a minimally invasive technique that makes it possible to treat many conditions through small incisions and dedicated instruments. It is used for rotator cuff tears, instability, subacromial impingement and some biceps injuries. It has the advantage of reducing the impact on the tissues and promoting a more controlled recovery.
In cases of complex instability or bone loss it may be necessary to resort to more advanced reconstructive techniques. These include joint stabilization and bone reconstruction procedures, defined according to the severity of the clinical picture.
In advanced forms of osteoarthritis, shoulder replacement is an effective solution for reducing pain and improving function. The choice between an anatomical and a reverse prosthesis depends on the condition of the rotator cuff, the quality of the bone and the type of joint degeneration.
The surgical pathway does not end in the operating room. The subsequent rehabilitation is an integral part of the treatment and significantly affects the final result.
04 — THE GROUP
The Shoulder Surgery Team of the NefroCenter Group’s Center for Complex Orthopedic Surgery
Shoulder surgery requires teamwork. Orthopedic surgeon, physiatrist, physical therapist, anesthesiologist and imaging diagnostics take part in a coordinated pathway, built around the needs of the individual patient.
Within the NefroCenter Group, Prof. Raffaele Russo is the reference specialist for shoulder and elbow surgery. Extraordinary Professor of Orthopedics and Traumatology, he is recognized for his experience in the management of complex joint conditions, instability, reconstructions and joint replacement surgery.
His contribution is part of the model of NefroCenter’s Center for Complex Orthopedic Surgery, designed to offer highly specialized pathways, from diagnosis to surgical and rehabilitative treatment.
Clinical cases treated by our team
The experience of the team of the NefroCenter Group’s Center for Complex Orthopedic Surgery is also expressed in the management of complex cases documented in the group’s editorial content.
These include elbow operations and highly complex reconstructive procedures, which help to convey the level of specialization of the team in advanced joint surgery as well.
All clinical cases are published with the patient’s consent and in compliance with privacy.
Read also: Center for Complex Orthopedic Surgery, Casa di Salute Santa Lucia
