Treating Shoulder Dislocation / Subluxation (Instability) and Associated Pain with Minimally Invasive Arthroscopy
Last updated Thursday, May 29, 2008
Preparing for surgeryPreparation Shoulder labral repair and
capsulorraphy surgery is considered for healthy and motivated individuals for whom
the pain and vulnerability to dislocation interferes with desired shoulder
function.
Successful 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 afterward (if ever). 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 skin that will be
involved in the surgery 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.
Postoperatively, the patient needs to plan on
being less functional than usual for six to twelve weeks. 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
labral repair and capsulorraphy can be delayed until the time that is best for
the patient's overall well-being. However, in cases of recurrent catching or
instability, excessive delays can result in the loss of bone and cartilage.
These losses can complicate the surgical procedure and can compromise the
quality of the surgery as well as its result.Costs The
patient’s insurance provider should be able to provide a reasonable estimate of
the surgeon's fee, the hospital fee, and the degree to which these are covered
by insurance.Surgical team Shoulder stabilization, particularly when done arthroscopically, is a
technically-demanding procedure that should be performed by an experienced,
specially-trained shoulder surgeon in a medical center. Your surgeon should be
performing complex arthroscopic shoulder procedures on a weekly basis. Patients
should inquire about the surgeon’s specific training for such procedures (e.g.,
fellowship training in sports medicine) to become a specialist familiar with
arthroscopic techniques and equipment. Patients might also ask how many of
these procedures the surgeon and the medical center perform on a yearly basis.Finding an experienced surgeon Surgeons who are
capable of performing simple arthroscopic procedures are readily available in
the community. However, complex reconstructive surgeries in the shoulder (e.g.,
arthroscopic stabilization procedures, arthroscopic rotator cuff repairs)
demand highly-specialized training. Most 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 and arthroscopic techniques, and
tailor the appropriate treatment to the problem to be addressed.
Fellowship-trained surgeons can be located through university schools of
medicine, county medical societies, state or national 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).Facilities Arthroscopic labral repair and capsulorraphy are usually performed in
qualified ambulatory surgical centers or major medical centers where such procedures
are common. These centers have surgical teams, facilities, and equipment
specially designed for this type of surgery. For those patients who must stay
overnight, the medical centers have nurses and therapists who are accustomed to
assisting patients in their recovery from shoulder surgery.Surgery for Cartilage and ligament tears in the shoulder 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 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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