Wockhardt Hospitals Blog

Normally a very active home-maker Mrs. Rina Gupta for whom multitasking at her household management was a vital and enjoyable job, had to gradually restrict her activities due to continuous shoulder & arm pain, stiffness and weakness of her shoulder muscle. Struggling to get the basic household work done, Mrs. Gupta restored to various medications and regular physiotherapy for pain relief but saw no signs of improvement. When the pain refused to go and her dependency on her family increased, Mrs. Gupta decided to visit Wockhardt Hospitals for a final opinion for her shoulder pain. At Wockhardt Hospitals she was diagnosed with subacromial impingement with bursitis and acromio-clavicular joint osteoarthritis – inflammation and pinching of the tendon of the rotator cuff and was advised to undergo arthroscopic surgery of her shoulder.

“Failing to bear the excruciating pain and being in a condition where I was dependant on my family members to perform basic household activity, I became frustrated and depressed not knowing how to get rid of this pain. During our routine visit to Wockhardt Hospitals, I decided to go for a final round of check up and that’s when we consulted Dr. Keyur Buch who explained accurately what problem I was suffering from and offered the option of key-hole, minimally invasive surgery” said Mrs. Rina Gupta.

“Subacromial impingement with bursitis and frozen shoulder are very common problems amongst the Indian population of 35 to 65 years; women more than men. Currently, most patients have no choice but to go for the medicinal therapies only, which don’t help a considerable number of patients. These patients end up either suffering long term, or visiting several doctors, specialists and alternative therapists, causing them much suffering, confusion, waste of time and also unrewarding expense” said Dr. Keyur A. Buch, Consultant Upper Limb & Arthroscopic Surgeon, Wockhardt Hospitals.

The four muscles that raise and lower the arm (and their respective tendons) are collectively known as the rotator cuff. The function of the rotator cuff is to push the main part of the shoulder down and away from the acromion when the arm is elevated. The space between the acromion and the rotator cuff tendons is filled by the subacromial bursa. This bursa is a fluid filled sac that allows for smooth gliding of the rotator cuff under the acromion with overhead movements of the shoulder.

Subacromial impingement develops if either the rotator cuff is injured (strained) or some bone deformity (usually a bone spur) is present under the acromion. The rotator cuff and acromion will then rub against one another, causing a painful condition known as impingement. Each time the arm is raised there is a bit of rubbing on the tendons and the bursa between the tendons and the acromion, which may cause pain and inflammation.

“Mrs. Gupta’s problem wasn’t an uncommon one, however usage of medicinal therapy over a period of time had masked her real problem and worsened her condition and she came to us with sever shoulder pain and complete stiffness of her right arm and we decided to perform arthroscopic surgery with coblation technique to correct her condition” added Dr. Keyur Buch.

Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and treatment of damage of the interior of a joint is performed using an arthroscope, a tiny camera inserted into the joint through a key hole incision. Arthroscopic procedures can be performed either to evaluate or to treat many orthopedic conditions including torn floating cartilage, muscle or tendon repair, ligament reconstruction, and treatment of shoulder dislocation, healing damaged cartilage etc.

The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. Instead a number of small incisions are made - one for the arthroscope and one or two for the surgical instruments. This reduces recovery time and may increase the rate of surgical success due to fewer traumas to the soft tissues. It is especially useful for athletes and also for the common populations, who frequently injure their shoulder & knee joints and require through diagnosis & proper treatment. There is also less scarring, because of the smaller incisions.

While arthroscopic surgeries are not new to India, Dr Keyur Buch is an orthoapedic surgeon with significant experience of using the most patient friendly new technology called Coblation technique at Wockhardt Hospitals. With the Coblation technique, Wockhardt Hospitals is able to offer treatment for various kinds of shoulder pains, frozen shoulder, torn muscles, tennis elbow, jumper’s knee, heel pains to name but a few conditions. The unique advantage of coblation technique is that the diseased tissues of various joints can be treated for the first time in India without any damage to the surroundings healthy tissues. It is definitely more tissue-friendly than laser or conventional radiofrequency or mechanical instruments.

“Today after the surgery my hand movement has improved to a great extent and I am able get my confidence and independence once again. With an extensive physiotherapy regime post surgery recovery has also been very speedy” said Mrs. Gupta.

The advantages of arthroscopic surgery of the joint with coblation technique are phenomenal – surgical pain is exceptionally reduced, post surgery recovery is very fast as compared to the traditional method, the hospital stay is reduced to a great extent, movement of the joint post surgery is almost back to normal and the patient can get back to his / her routine work within a very short span of time.