You will shortly be admitted to hospital for surgery, to try and prevent your shoulder from dislocating again.
Some patients will have chosen to have the operation carried out arthroscopically (keyhole surgery) and others will be having the operation through an incision at the front of the shoulder.
Surgery
- You will be admitted to hospital on the day of your operation.
- You will have been pre-assessed and various tests such as heart tracings and blood tests may have been carried out.
- You will be seen by nurses, doctors and occasionally by therapists according to your needs.
- Relatives/friends may stay for ten minutes while you book in at the theatre reception area on ward C3. Nurses will then help you get prepared for surgery, and you will meet the anaesthetist.
- The operation is performed with the shoulder numbed by a nerve block and a general anaesthetic. The actual operation lasts about 30-60 minutes, but you will also need some time to recover from the anaesthetic.
- When you wake up your arm will be supported in a poly sling attached by Velcro fastenings.
Please note
It is important that you only remove this as and when instructed.
If you have pain, you should make staff aware so that painkillers can be given.
After surgery
Your poly sling will be awkward to remove and apply and you will be taught how to do this.
Unless you are told otherwise, however, it is intended that you should wear this sling continuously for the first three weeks, as directed by your physiotherapist.
If the operation has been carried out through the arthroscope, it is not unusual for the shoulder to be swollen and for there to be leakage of blood stained fluid for the first 24 hours.
This should be considered normal, but please contact the ward if discharge persists.
You can remove the sling to wash but avoid lifting your arm far away from your side or turning your forearm away from your waist.
Most patients are allowed home on the evening of surgery.
Make sure to take painkillers regularly for the first day at least, as your shoulder is likely to be sore at night.
At home
You will be expected to rest the shoulder for the first three weeks after surgery.
After one week you can peel off the dressing and wash the wound gently.
You will be told if you have any stitches that need to be removed.
You can also start to use your hand to write, eat, wash, etc but avoid any lifting.
Important
Do not lift your arm above the level of your shoulder or turn the forearm outwards for six weeks after surgery.
This will be confirmed to you in physiotherapy.
Even if the arm feels comfortable (as they usually do!) it does not mean the repair is strong enough and to move too much at this stage risks undoing the operation and allowing further dislocations.
At three months you will be allowed to move your arm normally.
Important
You must still avoid heavy lifting, contact sports and anything that might cause a risk of you falling or having your operated arm pulled sharply.
A return to full use at six months is the aim and trying to get back quicker will result in a higher chance of further dislocations.
Possible complications
Serious complications are rare but according to published results the following are the more common problems seen after shoulder stabilisation:
- Nerve injury – 1%
- ‘Frozen shoulder’ – 2%
- Painful or ‘keloid’ scar – approx 2%
- Much more common is a further dislocation despite surgery and this is described in the results section that follows.
Results
No operation is 100% perfect and it is clear that at least
5-15% of people who have stabilisation surgery will still manage to dislocate their shoulder again, particularly those involved in contact sport.
Usually, however, the operation is being done because without it dislocation would be almost certain.
Perhaps 15-20% of people will find that even though the shoulder no longer dislocates they do not trust it as much in sport and therefore do not quite reach the level they managed before they started dislocating the shoulder.
Physiotherapy
Physiotherapy after stabilisation surgery is very important.
Important
At first however, you are asked to rest the arm.
After one to three weeks gentle movements are allowed and some physiotherapy may begin.
The most important treatment is between three and six months, when full movement of the arm is allowed.
This is the period when vital strengthening is carried out. This is not the sort of strengthening of the shoulder you may be used to and some shoulder exercises will be harmful so please maintain your contact with the physiotherapy department.
Long term
The purpose of this operation is to give you a chance of returning to sport and active work.
Normal function afterwards is the aim, though it is not uncommon for your arm to lose a few degrees of movement (people who dislocate often have more movement at the shoulder than others), so the range of movement is still usually normal even though it is a bit less than you had before surgery.
Dislocating your shoulder damages the joint and slightly increases your chance of getting arthritis in the shoulder in the future. We hope that by stopping dislocations
we can stop the arthritis, but to an extent some damage is already done.
Therefore, even after surgery you may still get arthritis of the shoulder. If there is already some damage to the joint you might still feel some of the catches and crunches that were present before surgery.
Useful contact numbers
If you have any concerns regarding surgery, please ring for advice:
