My name is Uma Srikumaran. I’m an orthopedic surgeon with Johns Hopkins and Howard County General Hospital. I specialize in shoulder surgery. Shoulder arthritis refers to degeneration of the lining of the joint. The lining of the joint is made of smooth cartilage that can wear out over time or can be diseased by inflammatory conditions such as rheumatoid arthritis or from a traumatic condition or posttraumatic arthritis after a shoulder dislocation.
The typical wear and tear arthritis is called osteoarthritis. Pain is the mostmon symptom of shoulder arthritis. Pain can occur throughout the day and worsen with certain activities. ing and catching may also be noticeding from the shoulder. As arthritis progresses the pain and stiffness will progress as well.
Nonsurgical treatment for shoulder arthritis includes simple measures such as rest and activity modifications or avoiding activities that are painful for your shoulder. Nonsteroidal antiinflammatory medications can also be beneficial for pain relief. Other options include icing, physical therapy and cortisone injections that may also provide symptomatic relief.
When nonsurgical treatments fail to provide pain relief over a period of time or the pain bes unbearable, surgical shoulder replacement surgery is an option. The goals of shoulder replacement surgery are pain relief as well as improved function so you may resume everyday activities.
The surgery is performed under general anesthesia often with a nerve block and involves an open incision in front of your shoulder. The arthritic bone is carefully removed along with scar tissue and a metal prosthesis and a plasticponent are inserted to recreate the ball and socket joint of the shoulder. Recovery after shoulder replacement surgery involves a one to two day hospital admission.
After this, an outpatient physical therapy program is performed usually beginning at two weeks after surgery and extending for several months. During this period patients are provided pain medications. Physical therapy will progress over several months. At first the therapist will guide the patient on passive range of motion exercises followed by active range of motion exercises in which the patient performs themselves. After a range of motion has been restored, strengthening exercises can begin.
How open femoral hernia surgery is carried out
This animation will show how a femoral hernia forms and how it’s treated with open surgery. A separate animation shows keyhole surgery. the navigation arrows below the animation screen to play, pause, rewind or fastforward the animation. This animation contains sound. Here we show the small bowel, abdomen and abdominal muscles. A femoral hernia is a lump that forms in the groin at the top of the thigh. It occurs when part of the contents of the abdomen, such as a bit of fat or part of the intestine bowel, pushes through a weakness in the abdominal wall into the femoral canal. The femoral canal is a passage at the top of the front of the thigh. It runs next to the blood vessels as they pass down from the abdomen into the thigh. Here we show the femoral hernia forming.
The aim of a hernia repair operation is to push the abdominal contents back in place and strengthen the weakness of the abdominal wall. You will be given injections of local anaesthetic. These willpletely block feeling in the groin area and you will stay awake during the operation. Alternatively a general anaesthetic may be used.
This means you will be asleep during the operation and feel no pain. Once the anaesthetic has taken effect, a single cut about 5 to 10cm long will usually be made in your groin. Here we show you where the cut will be made. The contents of the hernia will be pushed back in place. Your surgeon may stitch a synthetic mesh over the weak spot to strengthen the abdominal wall. The cut will be closed with dissolvable stitches and adhesive strips called Steristrips This is the end of the animation.
How keyhole abdominal aortic aneurysm surgery is carried out
This animation will show how an abdominal aortic aneurysm is repaired using keyhole surgery. the navigation arrows below the animation screen to play, pause, rewind or fastforward the animation. This animation contains sound. The abdominal aorta is an artery in the abdomen tummy which is connected to the heart.
An aortic aneurysm is a thin, weakened section of the aorta wall that bulges outwards. The aneurysm weakens the artery wall so it may not withstand the pressure of blood inside. This may cause it to rupture burst.
Surgery can repair the aorta. This may be emergency surgery if the aneurysm ruptures or elective that is planned surgery if an aneurysm is large and the risk of rupture is high. There are two main surgical options, keyhole surgery as shown in this animation and open surgery.
A small cut will be made in your groin and a catheter is passed up inside an artery in your leg until it reaches the area of the aneurysm. Apressed stent graft is fed to the site of the aneurysm. The procedure is guided using Xray. The stent graft is made of a tube supported by a metal mesh.
The stent graft is placed across the aneurysm. The stent keeps the aorta open and the aneurysm is protected from further pressure. The cut is closed with stitches and a dressing is placed over the stitches. This is the end of the animation. on the animation screen to watch it again.