Anterior glenoid reconstruction for unstable dislocating shoulders. Surgery to restore lost anterior glenoid bone and deep the socket with a bone graft can restore shoulder anatomy and lessen pain and improve function.
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Monday, October 09, 2006
Preparing for surgeryPreparation Iliac crest graft surgery is considered for healthy and motivated
individuals in whom instability after a previous repair interferes with
shoulder function.
Successful reconstructive surgery depends on a partnership between the
patient and the experienced shoulder surgeon. 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. Any heart, lung,
kidney, bladder, tooth, or gum problems should be managed before
surgery. Any infection may be a reason to delay the operation. The
shoulder surgeon needs to be aware of all health issues, including
allergies and the 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 area of the skin incision over the shoulder and hip 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
six to twelve weeks after the procedure. Driving, shopping and
performing usual work or chores may be difficult during this time.
Plans for 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. Timing Shoulder reconstruction with an iliac crest graft can be delayed until
the time that is best for the patient's overall well-being. However, in
the case of recurrent dislocations, excessive delays can result in the
loss of bone and tendon tissue. These losses can compromise the quality
of the surgery and its result.Costs The surgeon's office should provide a reasonable estimate of:
- the surgeon's fee and
- the hospital fee
Surgical team Revision instability surgery is a technically demanding procedure that
should be performed by an experienced surgeon in a medical center
accustomed to performing these reconstructions frequently. Patients
should inquire as to the number of similar shoulder procedures that the
surgeon performs each year and the number of these procedures performed
in the medical center each year.Finding an experienced surgeon Because these procedures
are performed infrequently in the United States each year, it is
unlikely that every community has a shoulder surgeon who performs many
of these procedures each year. Surgeons specializing in shoulder joint
reconstruction may be located through university schools of medicine,
county medical societies, or state orthopaedic societies. Other
resources include local rheumatologists or professional societies such
as the American Shoulder and Elbow Surgeons Society, which offers a worldwide directory of shoulder and elbow surgeons on its web site.
Facilities Shoulder reconstruction is usually 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 shoulder reconstruction
surgery.Surgery for failed surgery for anterior dislocation 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 206-598-BONE (2663) to make an appointment.
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