Throwing Injury Surgeries
If the patient does not respond to conservative treatment, surgery is considered when:
- Large tears in the tendon or other extreme damage to the elbow is the result of a sudden (acute) injury.
- The injury is the direct result of chronic overuse, and after six to twelve months of rehabilitation and tendon rest hasn’t relieved elbow pain.
- Elbow pain continues despite other treatments, such as acupuncture or corticosteroid shots.
- Loss of internal rotation of the shoulder has not responded to stretching exercises
- Shoulder pain has not responded to stretching and strengthening exercises, rest, or injections of cortisone
- MRI reveals labral or rotator cuff tears
The type of surgery performed depends on the pathology. However, commonly performed procedures in the throwing elbow include medial collateral ligament reconstruction (Tommy John procedure) and arthroscopic debridement. Commonly performed shoulder procedures include arthroscopic posterior capsular contracture release, labral repair, and rotator cuff repair.
Treatments
Arthroscopy
Most throwing injuries can be treated with arthroscopic surgery. During arthroscopy, the surgeon inserts a small camera, called an arthroscope, into the shoulder joint. The camera displays pictures on a television screen, and the surgeon uses these images to guide miniature surgical instruments.
Because the arthroscope and surgical instruments are thin, the surgeon can use very small incisions (cuts), rather than the larger incision needed for standard, open surgery.
During arthroscopy, your doctor can repair damage to soft tissues, such as the labrum, ligaments, or rotator cuff.
During arthroscopy, your surgeon inserts the arthroscope and small instruments into your shoulder joint.
Open surgery
A traditional open surgical incision (several centimeters long) is often required if the injury is large or complex.