Arthroscopic shoulder surgery for shoulder dislocation, subluxation, and instability: why, when and how it is done.
Edited By: Christopher J. Wahl, M.D., Suzanne L. Slaney, PA-C, ATC, MMS
Last updated Tuesday, January 25, 2005
Preparing for surgeryWhat type of preparation needs to take place before arthroscopic shoulder surgery for shoulder dislocation, subluxation, and instability? Surgical shoulder stabilization is considered for healthy and
motivated individuals in whom instability interferes with shoulder
function and activity.
Successful surgery depends upon a partnership between the patient
and the experienced shoulder surgeon. Patients should optimize their
health to prepare for surgery. Smoking should be stopped one month
prior to surgery, and be avoided altogether for at least three months
following surgery. Any heart, lung, kidney, bladder, tooth, or gum
problems should be managed before the shoulder surgery. Any active
infections will delay elective surgery to optimize the benefit and
reduce the risk of shoulder joint infection. The surgeon should be made
aware of any health issues, including allergies and non-prescription
and prescription medications being taken. Some medications will need to
be held or stopped prior to surgery. For instance, aspirin and
anti-inflammatory medications (Advil®, Motrin®, Alleve®, and other
NSAIDs) should be discontinued as they will affect intra-operative and
postoperative bleeding.
Before surgery, patients should consider the limitations,
alternatives and risks to surgery. Patients must recognize that the
procedure is a process and not an event: the benefit of the surgery depends a large part on the patient’s willingness to apply effort to rehabilitation after surgery.
Patients must plan on being less active and functional for 12 to 16
weeks after the surgery. Driving, shopping and performing overhead
chores, lifting, and repetitive arm activities may be difficult or
impossible during this time. Plans for the necessary assistance need to
be made before surgery. For individuals who live alone or those without
readily-available help, arrangements for home help should be made well
in advance. What about the timing of arthroscopic shoulder surgery for shoulder dislocation, subluxation, and instability? How long can it be safely delayed? Unless the shoulder is dislocated or stuck “out of joint”; shoulder
stabilization surgery can be delayed until the time that suits the
patient best. Persons who suffer several subluxations or dislocations
on a daily or weekly basis risk further injuries to the shoulder joint
or capsule that could compromise the surgical result.How can the costs of arthroscopic shoulder surgery for shoulder dislocation, subluxation, and instability be anticipated? The surgeon’s office should provide a reasonable estimate of:
- the surgeon’s fee
- the hospital fee, and
- the degree to which these should be covered by the patient’s insurance
Who should perform arthroscopic shoulder surgery for shoulder dislocation, subluxation, and instability and where? Shoulder stabilization, particularly when done through the arthroscope
is a technically demanding procedure that must be performed by an
experienced, specially trained shoulder surgeon in a medical center
accustomed to performing complex arthroscopic shoulder procedures on a
weekly basis. Patients should inquire as to the specific training the
surgeon has undergone to perform such procedures (i.e. a
fellowship-trained, sports medicine specialist familiar with
arthroscopic techniques and equipment) and also as to how many of these
procedures the surgeon and the medical center perform on a yearly basis.How can surgeons experienced in arthroscopic shoulder surgery for shoulder dislocation, subluxation, and instability be found? While surgeons who are capable of performing simple arthroscopic
procedures are relatively easy to find, complex reconstructive
surgeries in the shoulder (like arthroscopic stabilization procedures
and arthroscopic rotator cuff repairs) demand a degree of
highly-specialized training. Many capable surgeons will have completed
a fellowship (additional year or two of training) specifically in
arthroscopic techniques, shoulder surgery and sports medicine. A
qualified sports medicine surgeon should be comfortable with both open
(traditional) and arthroscopic techniques, and tailor the appropriate
treatment to the problem to be addressed. Fellowship-trained surgeons
may be located through university schools of medicine, county medical
societies, or state orthopaedic societies. Other resources include
professional societies such as the American Orthopaedic Society for Sports Medicine (AOSSM) or the American Shoulder and Elbow Surgeon’s Society (ASES).In what type of facility is arthroscopic shoulder surgery for shoulder dislocation, subluxation, and instability usually done? Arthroscopic shoulder stabilization is usually performed in a qualified
ambulatory surgical center or major medical center that performs such
procedures on a regular basis. These centers have surgical teams,
facilities, and equipment specially designed for this type of surgery.
For those patients who require an overnight stay, the centers have
nurses and therapists who are accustomed to assisting patients in their
recovery from shoulder stabilization.Surgery for shoulder dislocation, subluxation, and instability at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-543-1552 or 425-646-7777 to make an appointment.
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