Posterior glenoid osteoplasty for unstable dislocating shoulders. Surgery to build up the back of the glenoid socket using an osteotomy and graft can restore shoulder anatomy and lessen pain and improve function.

Preparing for surgery

Preparation

Posterior glenoid osteoplasty is considered for healthy and motivated individuals in whom recurrent posterior shoulder dislocations or apprehension interfere with shoulder function.

Successful posterior glenoid osteoplasty depends on a partnership between the patient and the experienced shoulder surgeon. The patient's motivation and dedication are important elements of the partnership. Patients should optimize their health so that they will be in the best possible condition for this procedure. Smoking should be stopped a month before surgery and not resumed for at least three months afterwards--ideally never. This is because smoking interferes with healing of the repair. All heart, lung, kidney, bladder, tooth, or gum problems should be managed before surgery. Any infection may be a reason to delay the operation.

The patient's shoulder surgeon needs to be aware of all health issues, including allergies and non-prescription and prescription medications being taken. Some of these may need to be modified or stopped. For instance, aspirin and anti-inflammatory medication may affect the way the blood clots. The skin around the shoulder must be clean and free from sores and scratches.

Before surgery, patients should consider the limitations, alternatives, and risks of surgery. Patients should also recognize that the result of surgery depends in large part on their efforts in rehabilitation after surgery.

The patient needs to plan on being less functional than usual for up to twelve weeks after the shoulder repair. Lifting, pushing, pulling, and some activities of daily living can place stresses on the repair. Performing usual work or chores may be difficult during this time. Plans for necessary assistance need to be made before surgery. For people who live alone or those without readily available help, arrangements for home help should be made well in advance.

The shoulder surgeon should answer any questions about the surgery or the recovery period.

Timing

Costs

The surgeon's office should be able to provide a reasonable estimate of:

• the surgeon's fee, and
  
• the hospital fee.
  

Surgical team

Finding an experienced surgeon

Surgeons specializing in shoulder instability surgery may be located through university schools of medicine, county medical societies, state orthopedic societies, or professional groups such as the American Shoulder and Elbow Surgeons Society, which offers a worldwide directory of shoulder and elbow surgeons on its web site.

Facilities

Posterior glenoid osteoplasty is often performed in a major medical center that performs these procedures on a regular basis. These centers have surgical teams and facilities specially designed for this type of surgery. They also have nurses and therapists who are accustomed to assisting patients in their recovery from this type of surgery.

10 surgery questions for your surgeon before having surgery

Surgery for posterior shoulder instability at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington

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