Treatments

Mr Durrant offers both surgical and non surgical treatments for injuries and conditions related to the shoulder, elbow, hand and wrist. His extensive training and expertise, combined with the latest advancements in his field, means that he can draw on his experience to ensure you are provided with the best options available for your treatment.

Combining your treatment options with an integrated rehabilitation programme allows for the optimal recovery, for every condition, for every patient.

When there is damage to the Acromioclavicular (AC) joint, which is the prominent bony ‘bump’ on the top of your shoulder, the person affected will often experience pain when performing overhead movements, such as throwing a ball, lifting something above their head, or reaching for something above head height.

Referred to as a shoulder separation, the treatment of an AC injury can involve surgery that is performed by arthroscopy. An arthroscopic AC repair involves a small narrow camera being inserted into the joint along with narrow instruments. The end of the collarbone (clavicle) is removed. The clavicle is then fixed into place. Arthroscopic surgery offers a faster recovery time when compared to open surgery, there is less risk of complications occurring, patients experience less pain with arthroscopic surgery, and scarring is reduced.

If the AC joint is very unstable surgery may have to be performed openly. A larger incision, a few centimetres in length, is made across the front top of the shoulder. After the end of the collarbone is removed, the ligament is then attached to the end of the cut bone. The recovery time after surgery is often greater with open surgery when compared to arthroscopic surgery.

With an AC injury, surgery is often the best option in order to regain movement of the shoulder and relieve pain. Arthroscopic AC repair surgery offers patients a very high chance of making a full and complete recovery from an AC injury.

Shoulder instability is a painful condition to live with. Many times it can become such a problem that range of motion and strength of the shoulder and arm are significantly reduced. With an unstable shoulder the likelihood of recurrent dislocations is high, and this can end up causing a great deal of damage to the bones, cartilage, ligaments and muscles in and around the shoulder joint. When a person suffers from shoulder instability, the best course of treatment is a surgical procedure referred to as an arthroscopic stabilisation.

An arthroscopic shoulder stabilisation involves a few small cuts being made into the shoulder, normally at the front and back of the shoulder. A small narrow camera, along with small instruments is inserted into these holes. The surgeon is able to view the inside of the shoulder without having to cut through skin, muscles and ligaments as would normally occur in an ‘open’ surgical procedure. This arthroscopic procedure, also known as a Bankart Repair, involves inserting suture anchors into the shoulder to reattach the torn or damaged ligament back onto the bone. The result is a firm tight ligament that supports the upper arm bone (humerus), holding it into place within its socket joint in the shoulder.

An arthroscopic stabilisation enables the patient to regain their shoulder strength and its stability, and the likelihood of the shoulder dislocating again is dramatically reduced. Recovery from an arthroscopic shoulder stabilisation procedure takes a few weeks. For the first three or so weeks the shoulder will remain immobilised, most likely in a supportive sling. Physical therapy exercises in the following weeks will help to build strength and movement within the joint. It will generally be a minimum of six weeks before you will be able to drive a car, go swimming, or perform any lifting. Over the following 12 months post surgery, the shoulder will continue to recover and gain in strength, stability, and range of motion.

An arthroscopic rotator cuff repair is an increasingly popular form of repairing a torn rotator cuff. The rotator cuff is a group of muscles and their tendons that surround the shoulder joint and provide stabilisation and strength to the shoulder. When a rotator cuff tear occurs the tendon that holds the upper arm bone, or humerus, into its socket has come loose or come away completely from the humerus. This causes a great deal of pain as well as destabilisation of the entire shoulder.

With an arthroscopic rotator cuff repair the torn tendon is repaired onto the bone using “anchors”. Any damaged and loose tissue is removed and sutures are threaded into the tendon. This sutured tendon end is then secured in place using these anchors which are inserted into humerus. An arthroscopic procedure involves a narrow camera and instruments into the joint through a few small incision holes, usually less than one centimetre in length.

The benefits of having a rotator cuff repair performed arthroscopically include a shorter recovery time, very little scarring, less pain experienced post operatively, and less likelihood of any complications occurring. Mr Durrant will discuss the option of an arthroscopic rotator cuff repair for your damaged shoulder.

Arthroscopic elbow surgery is an effective surgical procedure which can provide successful treatment of some elbow injuries, elbow arthritis, and other types of damage of the elbow.

An elbow arthroscopic surgical procedure involves a small narrow camera with a bright light that is inserted into the elbow joint through small cuts in the skin. Sterile water is also inserted into the joint to ‘inflate’ it and allow Mr Durrant to view the bone and tissues clearly. Using small specialised instruments Mr Durrant is able to smooth or remove any rough or damaged bone or tissue that may be causing problems; ligaments are also able to be tidied up or repaired.

Arthroscopic surgery is an excellent option for those who require surgical repair of their damaged elbow. Incision cuts are very small, and often only require one suture, making visual scaring very minimal. Post operative pain is minimal and easily managed, and recovery time is dramatically reduced when compared to ‘open’ surgical procedures. The likelihood of complications from surgery is reduced with an arthroscopic procedure. Common arthroscopic procedures performed include removing bony lumps that cause rubbing or pain, removing loose cartilage, muscle or tendon tissue, and loosening up cartilage to reduce stiffness experienced within the elbow joint.

Elbow epicondylitis is commonly known as tennis elbow. It is a painful condition caused by overuse of the forearm and elbow joint, where the tendon that attaches the forearm muscle to the outside of the elbow becomes inflamed. For the majority of patients, up to 90%, non-surgical treatment is successful in treating elbow epicondylitis. However for those who do not respond effectively to non-surgical treatment, referral to Mr Durrant is advised.

Surgical repair of elbow epicondylitis can be performed by arthroscopy or open surgery and depends on the severity of the damage. The operation involves removing damaged tendon tissue and reattaching healthy tendon to the bone. This tendon can be reattached using suture anchors, which are small metal pins that are inserted into the bone. Attached to these pins are sutures which are threaded through the healthy tendon. The sutures anchor the tendon into place on the bone.

Usually surgery is performed to repair elbow epicondylitis if non-surgical treatment has been attempted for six to 12 months with no success. Surgery to repair elbow epicondylitis is usually very successful. Patients who undergo elbow surgery generally notice relief from painful symptoms within a few weeks. It is generally expected to take four to six months before complete recovery from the symptoms of elbow epicondylitis is achieved and full strength of the forearm and elbow are regained.