Advice on Shoulder Stabilization
Before embarking on shoulder stabilization you should
be aware of the following facts. If you have any other questions you should ask your surgeon for further information.
Benefits
- Recurrent dislocation:
Shoulder stabilization is performed to prevent recurrent
dislocation. It is normally successful, with 85% of patients
having completely stable joints afterwards. A few patients
experience residual symptoms of instability, although the
shoulder no longer dislocates. Surgery fails to stabilize
the joint in about 1 patient in 20.
Risks
General risks
associated with any surgery
-
Cardiovascular problems: Heart attack and
stroke can occasionally be caused by anaesthesia and surgery.
The risks of this complication are normally exceedingly small in
healthy individuals. The risk may be greater if you have
pre-existing disease, in which case your anaesthetist / surgeon
will discuss this with you.
-
Thromboembolism: Blood clots may
sometimes form in the veins of your legs, a condition known as
'deep vein thrombosis.' This may cause excessive swelling of
your legs and may require treatment with blood thinning drugs.
Extremely rarely the clot may become detached and travel to the
lungs; this is a potentially fatal complication known as a
'pulmonary embolus.' There are some conditions in which the risk
of thromboembolism is increased (e.g. patients on the
contraceptive pill or HRT), in which case you may be given
medication to reduce the risk.
Specific risks of
subacromial decompression
-
Failure to relieve symptoms: About 5% patients
continue to dislocate their shoulders. 10% patients have the
sensation of instability but their shoulder no longer
dislocates.
-
Infection: Infection can complicate any
surgery. The risk following shoulder stabilization is small
.
In the event of an infection further surgery may be
required.
-
Stiffness: There is a small risk that
your shoulder may be stiff after surgery. The risk is
particularly great if you develop a post-operative
infection. The degree of stiffness rarely affects function.
-
Nerve and blood vessel injury: There is a very
small risk (<1%) of damage to nerves or blood vessels around
the shoulder.
Surgery details
-
Surgery will be done under general anaesthesia.
Your anaesthetist will discuss this with you. You may also have
a local anaesthetic injection to control post-operative pain;
again this will be discussed prior to surgery
-
The operation will take about 1
hour
-
An arthroscopy of the shoulder is often performed first (see
information sheet on subacromial decompression). It is
sometimes possible to stabilize the shoulder
arthroscopically through 2 or 3 very small incisions, but
more frequently an incision 5 to 8 cm long is made over the
front of the shoulder.
-
After surgery the arm will be immobilized in a sling.
-
It is usual to stay in hospital on the night following
surgery.
Recovery
-
You will be encouraged to
do gentle 'pendulum exercises' on the shoulder. These should
be done several times a day. At all other times however you
should wear a sling.
-
You should continue wearing your sling for 4 to 6 weeks.
-
After your sling has been removed you will require
physiotherapy to mobilize your shoulder.
-
Full shoulder movement is normally regained by 3 months.
-
It is normally possible to drive 6 to 8 weeks after surgery.
-
You should avoid contact sports for 6 months after surgery.
-
Your progress will be monitored by periodic outpatient
appointments.
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