Bankart repair for unstable dislocating shoulders: Surgery to anatomically and securely repair the torn anterior glenoid labrum and capsule without arthroscopy can lessen pain and improve function for active individuals.

Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Tuesday, November 13, 2007

Recovering from surgery

How much pain do patients usually have after surgical repair for shoulder dislocations for shoulder dislocations and what medications are used to manage it?

Recovery of comfort and function after shoulder instability surgery continues for many months. Shoulder instability surgery is a major surgical procedure that involves cutting of skin, removal of scar tissue, as well as suturing of tendons and bone. The pain from this surgery is managed by the anesthetic and by pain medications. Immediately after surgery, strong medications (such as morphine or Demerol) are often given by injection. Within a day or so, oral pain medications (such as hydrocodone or Tylenol with codeine) are usually sufficient.

Initially pain medication is administered usually 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 needed usually for only the first day or two after the procedure. Oral pain medications are needed usually for only the first two weeks after the procedure.

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.

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 benefits and 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 surgical repair for shoulder dislocations for shoulder dislocations, what happens in the hospital and when is the patient usually discharged?

After surgery the patient spends about an hour in the recovery room. A drainage tube is sometimes used to remove excess fluid from the surgical area. The drain is usually removed on the second day after surgery. Bandages cover the incision. They are usually changed the second day after surgery.

After surgical repair for shoulder dislocations for shoulder dislocations, what happens at hospital discharge and what are the patient's limitations at that time?

Patients are discharged as soon as:

• the incision is dry,
• the shoulder is comfortable with oral pain medications,
• the patient can perform the range of motion exercises,
• the patient feels comfortable with the plans for managing the shoulder, and
• the home support systems for the patient are in place.

Discharge is usually on the second day after surgery.

Patient limitations

Early protected motion after shoulder instability surgery is helpful for achieving optimal shoulder function. Depending on the nature of the procedure, the surgeon will often prescribe some gentle motion exercises within a limited range of movement.

Walking and use of the arm for gentle activities (with the elbow at the side) are often encouraged soon after surgery, but the surgeon should be consulted for the specifics of each individual case.

Gentle activities of daily living are often permitted with the operated arm; however, lifting anything heavier than a cup of coffee or using the arm for forceful activities must avoided for six to twelve weeks, depending on the procedure.

The surgeon often wishes to check the mobility of the shoulder two or three weeks after surgery, to assure that the shoulder has not become too stiff.

Management of the patient's limitations requires advance planning to accomplish the activities of daily living during the recovery period. Patients may require some assistance with self-care, activities of daily living, shopping, and driving for about one month after surgery.

Recovery of comfort and function after shoulder instability surgery continues for many months after the surgery. Improvement in some activities may be evident as early as three months. With persistent effort, patients make progress for as long as a year after surgery.

Surgery for shoulder dislocations at the University of Washington

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