the multiple joint deformities in these cases may necessitate a long programme of reconstructive or functional treatment , which entails whole-hearted co-operation on the part of the patient in intensive post-operative exercise regime.procedures advocated for the upper limb include excision of the acromion process together with the subacromial bursa to allow free movement between the central tendon of the deltoid and the tendinous shoulder cuff : arthrodesis of the shoulder in cases where there is more severe joint destruction : in certain cases of elbow-joint arthritis , excision of the radial head and sub-total synovectomy may preserve joint function and avoid or delay the necessity for arthroplasty which can be carried out in two ways : ( a ) similar to the formal joint excision , or ( b ) re-shaping the lower end of the humerus and upper end of the ulna lining these surfaces with fascia .
C0085515
tendinous
C0037004
shoulder