Schulterchirurgie Schweizer Paraplegiker-Zentrum

Shoulder Surgery

Shoulder pain is common among individuals with spinal cord injury. As wheelchair users rely on their arms to independently perform their day-to-day activities, the shoulder joint is subject to very heavy, and in some cases unphysiological strain..

A look at the everyday life of a wheelchair user suggests that the shoulder muscles are fatigued due to excess strain, primarily during transfer, meaning that the dynamic centring of the humeral head during movement is no longer guaranteed. This results in rapidly advancing joint damage.

Unfortunately, when a consultation takes place, the pain is often already permanent and it is no longer possible to treat it with non-surgical forms of therapy, or a significant loss of function has already taken place. In most cases, this means a disability in physical transfer, the process that determines independence in a paralysed individual.
 

Many years of experience

The Spinal Surgery/Orthopaedics department at the Swiss Paraplegic Centre (SPC) Nottwil has been offering standalone consultations for joints by Dr. med. Jacek Kerr since 2005. All surgical and non-surgical measures can be performed. Surgical interventions include arthroscopic (“keyhole technique”) reconstruction of tendons and ligaments, care for broken bones, implantation of endoprostheses, and the treatment of other injuries and illnesses of the upper and lower extremities. We provide comprehensive support and constant dialogue, working in collaboration with the Orthopaedics department of the Balgrist University Hospital in Zürich. Consultations, non-surgical therapy, and surgical therapy at the SPC are also available to patients who are not paralysed, but who may benefit from the Department’s particular experience in treating “challenging” shoulders.

Treatment services

  • Treatment
    Our treatment focuses both on surgical care for acute injuries of the locomotor system, and the treatment of degenerative damage to major joints. We predominantly use minimally invasive surgical techniques on the knee, shoulder, elbow and ankle joints.
    In contrast to open techniques, arthroscopic procedures involve very little surgical trauma, which has multiple advantages. The proprioceptive function which is essential to an intact joint is retained, with the result that sporting capacity can be quickly restored to the previous level. Furthermore, mobilisation can take place earlier, and the period of inpatient hospitalisation is much reduced. The minimally invasive procedure results in a lower level of morbidity, less post-surgical pain, and a more successful cosmetic result.


    Diagnosis
    Diagnosis and treatment are performed in accordance with the latest findings in medical research. Close collaboration with Sarnen Cantonal Hospital and the Swiss Paraplegic Centre enables cutting-edge imaging procedures to be used, including magnetic resonance imaging, for example, which is particularly helpful for diagnosing injuries in shoulders, knees and ankles.

  • Elbow
    In recent years, elbow arthroscopy has seen a particularly high level of development due to technical progress. This results in improved treatment options and a broader range of use. Diagnostic elbow arthroscopy is now able to represent all sections of the joint – which years ago was only possible by making multiple skin incisions. In the elbow, constriction arising from loose bodies, and stress-induced pain due to arthrosis make arthroscopic treatment necessary in most cases. There are further treatment options for cartilage and bone defects (including the assessment of bone breakages), in particular on the radial head but also in the other sections of the elbow joint. Loosening adhesions with significant restriction of movement, and the removal of inflamed joint mucosa (synovitis), particularly in the event of rheumatic illness, often represent good indications for shoulder joint endoscopy.


    Hand
    Carpal tunnel syndrome is also referred to as median nerve compression syndrome. It is the most frequently occurring entrapment syndrome, accounting for approximately 20% of all peripheral nerve damage that occurs. Women are affected significantly more frequently than men, and symptoms most often occur between the ages of 40 and 60, with the frequency of carpal tunnel syndrome currently increasing. One reason for this upward trend is the increased time individuals spend working at computers, and the associated keyboard and mouse operation. If other treatment methods have failed to cure or alleviate symptoms, or if the illness is at an advanced stage, surgery should be performed. In particular, surgery is necessary if initial indications of paralysis have occurred, and it should not be delayed too long. Functional restriction to the damaged nerve regresses only slowly, and may persist for some time even after successful surgery. In the event of severe nerve damage, complete restoration of the nerve function cannot always be achieved.

  • Treatments we offer:

    • Rotator cuff
    • Impingement syndrome
    • Tendinitis calcarea (calcareous shoulder)
    • Shoulder instability
    • Pathologies of the long biceps tendon (SLAP lesion)
    • Osteoarthritis of the shoulder joint
  • Osteoarthritis of the hip joint (coxarthrosis)
    The most frequent cause of disorders affecting the hip joint is cartilage wear, which can result in osteoarthritis, or “coxarthrosis”. The joint increasingly loses its fit, the bone forms deposits around its edges, and the resulting wear causes pain on an ongoing basis. The loss of cartilage results in increasing stiffening of the joint. At the same time, pain occurs after periods of activity, on exertion, late at night, and at rest, resulting in reduced walking distance and ultimately restriction of quality of life.


    Hip endoprosthesis (total hip replacement)
    When non-surgical treatment measures (physiotherapy, complementary measures, massages, anti-inflammatory indications) no longer help and pain has become too great, it’s time for surgical intervention.
    A hip endoprosthesis is the longest-established joint replacement in common use. However, surgical techniques and the material used have been improved so much in the last 20 years that the useful life of a hip prosthesis can now be measured in decades. Both the femoral head and the acetabulum need to be replaced in the event of hip osteoarthritis.
    This procedure has become one of the most frequently employed and most successful routine operations in orthopaedic surgery (with approximately 400,000 taking place across Europe each year).
    The prosthesis is modelled on the structures as they naturally occur in people, i.e. it consists of a socket and a shaft onto which a spherical head is attached. With the aid of pre-surgical planning diagrams, the prosthesis size and position are determined, taking into account individual patient needs (such as age, gender, bone shape, bodyweight, and other factors).

  • The knee is the largest joint in the human body. It is made up of three bones: the femur, tibia and patella. It is stabilised by the surrounding muscles and ligaments (cruciate and lateral ligaments). In addition, the meniscae go through the joint, stabilising it, serving as shock absorbers, and distributing pressure. As is the case with all other joints, the knee is also covered by a layer of cartilage. 

    Treatments we offer:

    • Ligaments
    • Cartilage damage
    • OATS (Osteochondral Autologous Transfer System)
    • MACI / ACT
      (Matrix Associated Chondrocyte Implantation / Autologous Chondrocyte Transplantation)
    • Microfracturing (“Pridie- drilling”)
    • Corrective osteotomy
    • Osteoarthritis
  • Treatments we offer:

    • Hallux valgus
    • Hallux rigidus
    • Hammer toe / claw toe
    • Tailor’s bunion/bunionette (bunion on the little toe)

Our specialists

  • Dr. med. Martin Baur

    Head of Spinal Surgery and Orthopaedics
    martin.baur@paraplegie.ch

    Dr. med. Martin Baur – CV

    Since 2014
    Head of Department at the Swiss Spine and Spinal Cord Centre (CH) at SPC Nottwil and Lucerne Cantonal Hospital (LUKS), in Lucerne


    Since 2014
    Head of Department of Spinal Surgery and Orthopaedics at the Swiss Paraplegic Centre (CH)


    Since 2014
    Consulting Physician and Affiliated Doctor in Spinal Surgery and Orthopaedics at the Nidwalden Cantonal Hospital (CH)


    Since 2013
    Head of Department of Interdisciplinary Spinal Surgery (Prof. Babst) at the Lucerne Cantonal Hospital (CH)


    Since 2011
    Consulting Physician and Affiliated Doctor in Spinal Surgery and Orthopaedics at the Zug Cantonal Hospital (CH)


    2011
    Co-Head of Department of Neurosurgery and Interdisciplinary Spinal Surgery (Prof. Babst) at the Lucerne Cantonal Hospital (CH)


    2007
    Senior Consultant in Interdisciplinary Spinal Surgery at the Lucerne Cantonal Hospital (CH)


    2004
    Chief Physician in Neurosurgery (Prof. Hildebrandt) at the St. Gallen Cantonal Hospital (CH)


    2003
    Chief Physician in Neurosurgery (Prof. Lanner) at the Landeskrankenhaus Klagenfurt (A)


    2003
    Assistant and Chief Physician in Neurosurgery (Dr. Oeckler) at the Zentralklinikum Villingen-Schwenningen (D)


    2002
    Specialist in Neurosurgery. Freiburg im Breisgau. (D)


    2000
    Fellowship in Accident and Spinal Surgery (Prof. Hertlein) at the Städtisches Krankenhaus München-Harlaching (D)


    1997
    Specialist in Surgery, Freiburg im Breisgau (D)


    1992
    Junior Doctor for General, Thoracic and Vascular Surgery (Prof. Rühland/Dr. Rehbein) as well as Consulting Physician and Emergency Physician in Air Ambulance Services at Klinikum Singen (D) and Rottweil (D)


    1989
    Assistant for Emergency Surgery (PD Henkemeyer) at the Zentralklinikum Villingen-Schwenningen (D)


    1988
    State examination at the University of Freiburg im Breisgau (D)

     

    Memberships

    - SGS (Swiss Society of Spinal Surgery)
    - SGN (Schweizerische Gesellschaft für Neurochirurgie – Swiss Society of Neurosurgery)
    - DGW (Deutsche Gesellschaft für Wirbelsäulenchirurgie – German Society for Spine Surgery)
    - DGWF (Deutsche Gesellschaft für Wirbelsäulenforschung – German Society for Spine Research)
    - BDC (Berufsverband Deutscher Chirurgen – Association of German Surgeons)
    - AO Spine (Association for the Study of Osteosyntheses)
    - NASS (North American Spine Society)

     

  • Dr. med. Jacek Kerr

    Consulting Physician for Shoulder Surgery

    Dr. med. Jacek Kerr

    Since 2014
    Ortho-Care Praxis Kriens (Kriens Orthopaedic Care Practice)


    Since 2006
    Zofingen practice – self-employed


    Since 2005
    Head of the Shoulder Surgery Department at the SPC Nottwil

    2004-2008
    Spinal Surgery: Consulting Physician in the Orthopaedics and Spinal Surgery Department at the Swiss Paraplegic Centre Nottwil (CH)


    2002-2004
    Consulting Physician/Representative of Head of Department for Sports Clinic Stuttgart


    1999-2002
    Trauma surgery: Rechbergklinik Bretten, teaching hospital of the University of Heidelberg


    1998-1999
    Junior partner for Orthopaedic Rheumatology at an orthopaedic and rheumatological practice clinic, Städtisches Klinikum Lüneburg (Lüneburg Community Hospital)

     

    1993-1998
    Orthopaedics: St. Marien-Krankenhaus, Siegen, teaching hospital of the University of Marburg


    1989-1993
    Surgery: General and vascular surgery: St. Josef-Hospital, Oberhausen

     

    Fellowships

    2003 Steadman-Hawkins Clinic, Foundation
    2001 New York Medical College, Orthopaedic Department Saint Vincence Hospital
    1999, 2000, 2006 Department for Sports Orthopaedics at the Technical University of Munich (Prof. A. B. Imhoff)

     

    Fields of study and additional qualifications

    2009 Proficiency certificate from the Schweizerische Gesellschaft für Ultraschall in der Medizin (Swiss Association for Ultrasound in Medicine, SGUM) – locomotor system
    2006 Orthopaedic Surgery and Traumatology of the Locomotor System (CH)
    2002 Completion Certificate for the Magnetic Resonance Imaging Curriculum
    1998 Sports Medicine (D)
    1997 Orthopaedic Specialist (D)
    1996 Chirotherapy (D)
    1996 Technical Knowledge in the Sonography of the Support and Movement Organs
    1995 Technical Knowledge in Radiation Protection and X-ray Diagnosis
    1995 Doctorate from the University of Essen

     

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