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 Friday, October 16, 2009
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Recovering from surgery
How much pain do patients usually have after surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation and what medications are used to manage it?
The shoulder and hip are painful after the surgery. Pain in the hip
area may make walking uncomfortable for several weeks after surgery. A
cane held in the opposite hand may be helpful in walking afterwards.
For this reason, the bone graft is usually harvested from the same side
as the shoulder surgery. Recovery of comfort and function after
shoulder reconstruction continues for the first year after surgery.How are medications after surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation administered? How long will they be needed?
Initially pain medication is usually administered intravenously or
intramuscularly. Sometimes patient controlled analgesia (PCA) is used
to allow the patient to administer the medication as it is needed.
Hydrocodone or Tylenol with codeine are taken by mouth. Intravenous
pain medications are usually needed only for the first day or two after
the procedure. Oral pain medications are usually needed only for the
first two weeks after the procedure.How does pain medication usually affect pain and comfort following surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation?
Pain medications can be very powerful and effective. Their proper use
lies in the balancing of their pain relieving effect and their other,
less desirable effects. Good pain control is an important part of the
postoperative management.What are the most frequent and most serious side effects of taking pain medication after surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation?
Pain medications can cause drowsiness, slowness of breathing,
difficulties in emptying the bladder and bowel, nausea, vomiting and
allergic reactions. Patients who have taken substantial narcotic
medications in the recent past may find that usual doses of pain
medication are less effective. For some patients, balancing the benefit
and the side effects of pain medication is challenging. Patients should
notify their surgeon if they have had previous difficulties with pain
medication or pain control.After surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation, what happens in the hospital and when is the patient usually discharged?
After surgery the patient spends an hour or so in the recovery room.
Drainage tubes are usually used to remove excess fluid from the
surgical areas. The drains are usually removed on the second day after
surgery. Bandages cover the incisions. They are usually changed the
second day after surgery.
Patients are discharged as soon as the incisions are dry, the shoulder
and hip are comfortable with oral pain medications, the patient can
perform the range of motion exercises, the patient can walk
independently and the home support systems for the patient are in
place. Discharge is usually on the third or fourth day after surgery.
What is the recovery from surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation? What type of rehabilitation is started in the hospital?
Early motion after shoulder reconstruction helps achieve the best
possible shoulder function. Initially, the patient is encouraged to
rotate the arm through a limited range that is defined by the surgeon.
During the hospitalization, the patient learns the simple
rehabilitation program that will be used for maintaining the range of
motion at home after discharge. On the day of surgery or the day after,
the physical therapist teaches the patient gentle range of motion
exercises. Walking and use of the arm for gentle activities are
encouraged soon after surgery.
After surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation, what happens at hospital discharge and what are the patient's limitations at that time?
At the time of discharge, the patient should be relatively
comfortable on oral medications, have dry incisions, understand their
exercises, and feel comfortable with the plans for managing the
shoulder and the hip. For the first month or so after this procedure,
the operated arm may be less useful than it was immediately beforehand.
The specific limitations can be specified only by the surgeon
who performed the procedure. It is important that the repaired tendons
not be challenged until they have had a chance to heal. Usually the
patient is asked to lift nothing heavier than a cup of coffee for six
weeks after the surgery. Management of these limitations requires
advance planning to accomplish the activities of daily living during
the period of recovery.
What type of help do patients need after surgery to deepen the socket of anteriorly dislocating shoulders (using an anterior iliac crest bone graft) for failed surgery for anterior dislocation and for how long? Can they go home or do they require a convalescent facility?
Patients usually require some assistance with self-care, activities
of daily living, shopping, and driving for approximately six weeks
after surgery. Patients usually go home after this surgery, especially
if there are people at home who can provide the necessary assistance,
or if such assistance can be arranged through an agency. In the absence
of home support, a convalescent facility may provide a safe environment
for recovery.
Recovery of comfort and function after shoulder reconstruction
continues for many months after the surgery. Improvement in some
activities may be evident as early as six weeks. With persistent
effort, patients make progress for as long as a year after surgery.
Surgery for failed surgery for anterior dislocation at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
If you are interested in making an appointment to discuss this procedure in Seattle, 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. Our clinical center is located in Seattle Washington, USA
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