The focus of the treatment is on restoring mobility to the shoulder. Targeted strengthening of the surrounding muscles relieves the damaged area. Further relief is achieved by stretching and mobilizing the shrunken joint capsule in order to take the pressure off the joint.
Successful surgical treatment with appropriate physiotherapy can therefore normally restore full shoulder function.
This can improve the healing of the muscle and the tendon plate. This also leads to a reduction in pain and an improvement in mobility. We usually recommend 3-5 ACP treatments.
This is how ACP supports healing processes in the shoulder joint:
Many injuries in the human body heal themselves. Behind these complex healing processes are growth factors from the blood.
During treatment with ACP, blood is taken from the patient using a small special syringe, similar to the way you would have a blood test at your GP.
This blood is then specially processed so that only the growth factors responsible for healing remain in a highly concentrated form.
The body's own active ingredient obtained in this way is then injected into the affected tendon. At the site of the injection, the body's healing mechanisms kick in, the inflammation and associated swelling recede and the tendon is supported in its healing process.
The infiltration of hyaluronic acid can lead to an improvement in joint function, particularly in the case of an osteoarthritic shoulder joint. The mobility of the joint increases again and pain decreases.
More about hyaluronic acid in the shoulder joint:
Hyaluronic acid is the most important component of synovial fluid and occurs naturally in every human joint. It acts in many ways in the joint - as a shock absorber, spacer and lubricant. It also helps to nourish the cartilage.
Cartilageis not supplied with blood, but is supplied passively by absorbing and releasing synovial fluid during movement. As an essential component of synovial fluid, hyaluronic acid ensures the elasticity of the cartilage and thus its resilience as a shock absorber.
If a joint is injured or inflamed, the amount of hyaluronic acid and therefore the natural lubricant in the joint decreases. The joint surfaces rub more against each other and the inflammation and joint wear continue - a vicious cycle for the joint.
By injecting additional hyaluronic acid into the affected joint, the cycle is stopped, the joint is better lubricated again and runs "smoother" - swelling and pain are reduced.
Shock wave therapy can be used to improve blood circulation, reduce pain and improve mobility. However, it is not possible to heal the tendon in the event of a complete tendon rupture.
Shockwave therapy is normally used 5-6 times once a week.
Acupuncture can be used very well as supportive pain therapy and to reduce the tendency to swell in osteoarthritis.
1x - 2x per week for 10 weeks
During the operation, which is performed arthroscopically using the keyhole principle without a large incision, the tendon is reattached to the bone using a dissolving biological anchor. Normal tendon-bone healing occurs after 6 weeks, allowing the shoulder and muscles to be fully functional again.
In today's modern shoulder surgery, it is no longer necessary to open the shoulder joint via an incision. As a result, the symptoms usually subside completely after a few days and the shoulder can be moved passively up to 90° without any problems by an appropriate physiotherapist and also with a motorized chair that is delivered to the patient's home. Active movement of the shoulder joint is only permitted from the 6th week onwards.
In minimally invasive surgery, the torn/teared tendon is reattached to the bone using a biodegradable anchor with the help of a very small camera and arthroscopic instruments.
Nopost-operative bleeding or major swelling:
We can prevent post-operative bleeding by using the latest gentle surgical instruments (Apollo), avoiding large incisions and treating the smallest of bleedings intraoperatively. This significantly reduces the pressure on the joint capsule and means much less, and in many cases even no, significant pain after the operation.
Nodrainage:
This means we can almost always dispense with the insertion and subsequent removal of a drain.
Specialpain blockade:
Intraoperatively, patients receive an injection into the nerves of the arm to block pain so that they do not feel any pain for up to 24 hours immediately after the operation. As most of the body's reaction processes and therefore pain occur in the short time directly after the operation, patients should feel almost no pain once the pain blockade has worn off.
Nostitches necessary:
Theuse of self-dissolving cosmetic sutures means that our patients no longer need to remove stitches.
The operation usually takes 45 to 60 minutes and is performed under general anesthesia.
This operation is usually performed as an inpatient procedure. You will arrive on the day of the operation. The day after the operation, you will have your first physiotherapy session. You can leave the hospital in the morning on the second day.
From the first day after the operation, patients begin passive movement exercises in physiotherapy and lymphatic drainage.
The orthosis must be worn until the 6th week, but can be removed for showering. A drain is generally no longer inserted due to our gentle surgical method, meaning that patients no longer have to painfully remove the drain.
Showering is possible from the 4th postoperative day.
Absorbable (self-dissolving) stitches are used so that it is no longer necessary to remove the stitches. For this reason, bathing and saunas should be avoided for 10 days.
You should wait until the 6th week before starting active exercises.
The arm can be moved passively immediately after the operation. Active movement in the shoulder joint may only be performed after the 6th week, as the tendon on the bone has only fully healed after 6 weeks.
Writing or typing on the computer is already possible on the 2nd day after the operation.
More active movements, such as lifting the arm sideways, are only possible once the tendon has fully healed on the bone - i.e. 6 weeks after the operation. Personal hygiene, especially showering, is usually possible again 3 days after the operation without a plaster.
Sports that do not put a lot of strain on the shoulder, such as jogging, can be performed from the 6th week onwards.
For sports in which the arm is raised above 90°, breaks of up to 12 weeks may be necessary.
We will be happy to advise you and create an individual weight-bearing plan for you.
In order to maintain strength and function in the shoulder joint, even non-athletes require surgical treatment, especially in the case of a complete tendon rupture. Similar to a hole in a sock that you continue to wear every day, otherwise the hole will get bigger and bigger and the function of the joint will get worse and worse. Above all, without surgery or appropriate treatment (e.g. ACP), severe osteoarthritis regularly develops over the years.
Discomfort in the shoulder joint area increases, function and mobility decrease. Strength decreases and, sooner or later, severe osteoarthritis develops in the shoulder joint.
With today's special, minimally invasive techniques, complications are extremely rare. The worst and extremely rare complication would be a joint infection.
As our arthroscopic surgery involves a lot of fluid irrigation, an infection practically never occurs, as in most cases an antibiotic is given as a one-off prophylaxis in the operating room shortly before the operation. Should an infection nevertheless occur, an antibiotic would have to be administered. It may be necessary to rinse the joint again.
There is usually no risk of major injury to the tendon, bone or nerves.
