SHOULDER SURGERY STELLENBOSCH
by Dr Joe de Beer
Welcome to The Cape Shoulder Institute in Stellenbosch Winelands
Dr Joe de Beer – Shoulder surgery Stellenbosch
The Cape Shoulder Institute was founded by Dr Joe de Beer in 1998, who has successfully operated on thousands of shoulders, including international sportsmen in all sport categories. Dr Joe de Beer, a renowned shoulder surgeon, now practices in Stellenbosch at the Mediclinic Winelands Orthopaedic Hospital, shoulder unit. To contact or request an appointment to see Dr Joe de Beer, please see the following links, Contact Us or Request an Appointment.
We specialise is the following shoulder treatments and surgery.
Shoulder Surgery Stellenbosch
Shoulder Surgery
Reverse Shoulder Replacement
This 73-year-old gentleman had longstanding severe arthritis of his shoulder – it caused pain, and he had virtually no motion in the joint whatsoever (referred to as ankylosis).
A Reverse prosthesis was implanted, and he immediately had a great range of motion, and pain relief.
Photo taken one day post-operatively
Shoulder Surgery Article
Contributions to Shoulder Surgery in South Africa | Dr Joe de Beer
Contribution to Arthroscopic Knot-tying
When arthroscopic surgery of the shoulder started gaining relevance in the 80’s, it became necessary to do knot-tying through cannulas for labral repairs and rotator cuff repairs. The first ones (e.g. Fisherman’s knot) could slide forward, but backwards as well – not keeping tension on the repair. He developed the Nicky’s knot, which was a “ratchet knot” and kept its tension after sliding it down to the tissues.
This knot is still widely used all over the world today.
De Beer JF, van Rooyen K, Boezaart AP. Nicky’s knot–a new slip knot for arthroscopic surgery. Arthroscopy -1998 Jan-Feb;14(1):109-10. PubMed PMID: 9486346.
There have been 92 citations of this article.
Photo: Nicky’s Knot
Shoulder Surgery Article
Contributions to Shoulder Surgery in South Africa | Dr Joe de Beer
Considerations about bone loss of the Glenoid in Shoulder Instability
Due to his management of numbers of rugby players with shoulder instability, it became clear to him that arthroscopic Bankart’s had significant failure rates due to bone loss, and that there was a need to address the bone and not only the soft tissue.
He started to collaborate with Dr Steve Burkhart (Texas USA), and did scientific follow up of their Bankart procedures, which revealed a 60% failure rate if bone loss was present.
He considered the Latarjet procedure as a solution, and modified it to the “Congruent Arc Latarjet” which used the concavity of the coracoid to align with the glenoid arc.
Their first article was regarded as a watershed article on the topic.
Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy – 2000 Oct;16(7):677-94. PubMed PMID: 11027751.
There have been 1,982 citations of this article and regular mentioning at academic congresses.
This was followed by a few studies on bone loss and anatomical appearance: the most quoted was his observation that with arthroscopic viewing the glenoid lost its pear-like appearance and he coined the term “inverted pear”
Photo The Latarjet Procedure
Shoulder Replacements
Latest Developments in Shoulder Arthroplasty
Dr de Beer has been performing Reverse Shoulder Arthroplasty for 25 years, and has participated in the development and perfection of these prosthesis.
New methods and new models are continuously invented.
Dr de Beer feels that the major new development in the surgical technique, is through the deltoid and subscapularis sparing approach. In this surgical approach the muscles are not cut to insert the prosthesis, then requiring them to be repaired.
Usually, the subscapularis is cut to insert the prosthesis into the humeral shaft, and glenoid and then repaired. This requires the shoulder to be immobilised in a sling 4-6 weeks following the procedure, to allow the tendons to heal. That may lead to stiffness and prolonged rehabilitation.
By inserting the prosthesis without cutting the muscles, allows for immediate motion, pain is diminished and rehabilitation is much quicker and simpler.
Photo: This patient on the same day of her shoulder replacement
Rotator Cuff Tears
What is a Rotator Cuff Tear?
Most Rotator Cuff Tears are as a result of degeneration or “wear and tear”. The circulation to the tendon becomes impaired in older people and leads to degenerative tears. Another cause may be impingement by the overlying acromial bone spur. Injuries, such as a fall, can result in traumatic tears when a fall or an other forceful mechanism tears the tendon off its insertion site on the greater tuberosity.
What are the early signs of a Rotator Cuff Tear?
Pain at rest and at night, especially lying on the shoulder.
Pain when lifting and lowering your arm.
Weakness when lifting or rotating your arm.
Crackling sensation when moving your shoulder in certain positions.
Most Rotator Cuff Tears tendinitis questions asked.
What is a Rotator Cuff Tear?
Most Rotator Cuff Tears are as a result of degeneration or “wear and tear”. The circulation to the tendon becomes impaired in older people and leads to degenerative tears. Another cause may be impingement by the overlying acromial bone spur. Injuries, such as a fall, can result in traumatic tears when a fall or an other forceful mechanism tears the tendon off its insertion site on the greater tuberosity.
What are the early signs of a Rotator Cuff Tear?
Pain at rest and at night, especially lying on the shoulder.
Pain when lifting and lowering your arm.
Weakness when lifting or rotating your arm.
Crackling sensation when moving your shoulder in certain positions.
How long do I stay in hospital after Rotator Cuff Tear surgery?
Rotator Cuff Tear surgery is done the same day and requires no overnight hospitalization.
What is the recovery time after Rotator Cuff Tear surgery?
It takes the repaired rotator cuff tendons about six weeks to heal, and three months to form a relatively strong attachment to the bone, and about six to nine months before the tendon is completely healed to the bone.
Should I wear a brace after Rotator Cuff Tear surgery?
Patients are often advised to wear a sling or brace for the first 4 to 6 weeks after rotator cuff repair surgery to prevent them from performing any physical activities.
What exercises can I do after Rotator Cuff Tear surgery?
Do not lift, push or pull. Do not rush for recovery to get well. Dr Joe de Beer will advise on the rehabilitation. Intensity of the tear as well as age will determine the rehabilitation path to follow.
Calcific Tendinitis
What is calcific tendinitis of the shoulder?
Calcific tendinitis of the shoulder is an acute or chronic painful condition due to the presence of calcific deposits inside or around the tendons of the rotator cuff; The calcium deposit is a paste-like material in the tendon. The calcium deposit accumulates in the substance of the tendon and one of the reasons for the pain could be that the fibres of the tendon are pushed apart by the bulk of the calcium.
What are the early signs of a calcific tendinitis?
Usually, calcium deposits in the shoulder cause severe shoulder pain and stiffness. Often, pain is so severe that sleeping is difficult. In addition, lifting the arm in different directions is limited. X-ray of the shoulder shows larger hard deposits.
Most common Calcific Tendinitis questions asked.
What is calcific tendinitis of the shoulder?
Calcific tendinitis of the shoulder is an acute or chronic painful condition due to the presence of calcific deposits inside or around the tendons of the rotator cuff; The calcium deposit is a paste-like material in the tendon. The calcium deposit accumulates in the substance of the tendon and one of the reasons for the pain could be that the fibres of the tendon are pushed apart by the bulk of the calcium.
What are the early signs of a calcific tendinitis?
Usually, calcium deposits in the shoulder cause severe shoulder pain and stiffness. Often, pain is so severe that sleeping is difficult. In addition, lifting the arm in different directions is limited. X-ray of the shoulder shows larger hard deposits.
How long do I stay in hospital after calcific tendinitis surgery?
The operation lasts about half an hour on average, and requires about 2 days in hospital.
What is the recovery time after calcific tendinitis surgery?
Recovery after calcific tendonitis surgery is gradual. Patients usually take one to two weeks off from work. Physical therapy may be required for a proper recovery, usually for several months.
Should I wear a brace after calcific tendinitis surgery?
You may have to wear a sling to support and protect the shoulder for a few days after surgery.
What exercises can I do after calcific tendinitis surgery?
It has also been found that exercising other areas of the body can improve the function of your painful shoulder; so, general exercise such as walking, swimming, or cycling is encouraged. Refrain from jerky, jolting movements.
Frozen Shoulder
What is a frozen shoulder condition?
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
What are the early signs of a frozen shoulder?
- Severe pain and restriction of movement.
- Night pain, difficulty sleeping.
- Reaching the hand up behind the back is usually a
- problem due to the restriction.
- Pain in the upper arm.
Most common Frozen Shoulder questions asked.
What is a frozen shoulder condition?
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
What are the early signs of a frozen shoulder?
- Severe pain and restriction of movement.
- Night pain, difficulty sleeping.
- Reaching the hand up behind the back is usually a
- problem due to the restriction.
- Pain in the upper arm.
How long do I stay in hospital after frozen shoulder surgery.
You may feel a moderate amount of pain, depending on severity. You usually stay in the recovery room for at least two hours while the anesthetic wears off. General anesthesia wears off in about an hour and regional anesthesia may take about two hours to wear off.
What is the recovery time after frozen shoulder surgery?
After surgery, physical therapy is necessary to maintain proper motion. Recovery times vary, from 6 weeks to 3 months. Although it is a slow process, your commitment to therapy is the most important factor.
Should I wear a brace after frozen shoulder surgery?
After surgery, your doctor may require you to wear an arm splint to keep the capsule of the shoulder in place. Physical therapy is essential to help you regain strength and flexibility in the joint.
What exercises can I do after frozen shoulder surgery?
While keeping your shoulder movable is vital to healing and recovery, you still need to refrain from pulling, jerking and jolting your arm. These impair healing add more strain to your muscles.
Understanding Your Shoulder Pain
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Shoulder Conditions
Are you experiencing shoulder pain? View all the shoulder conditions Dr Joe de Beer offers treatments and surgery of the following shoulder conditions.
See Our Locations
Find us at Stellenbosch, Mediclinic Winelands Orthopaedic Hospital and at The Cape Eye Hospital in Bellville.
Meet Dr Joe de Beer
Dr Joe de Beer is known internationally as one of the top shoulder surgeons, with decades of shoulder surgeries, offering the best in technology & experience.