Shoulder Stabilization Surgery

Shoulder Stabilization Surgery

Anterior Stabilisation | Posterior Stabilisation | Laterjet

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Contact Information:

• Sulis Hospital: 01761 422222
• Bath Clinic Circle Health Group: 01225 809343
• St Joseph’s Hospital: 01633 820344

1. INTRODUCTION

This booklet provides guidance on managing shoulder pain and surgery recovery. It complements professional medical care and advice from your Orthopaedic Consultant and Physiotherapist.

2. SUMMARY

The shoulder’s stability relies on the labrum and rotator cuff muscles.

• Symptoms: Pain, apprehension, subluxation, dislocation.
• Treatment: Surgery or non-surgical options based on assessment.
• Post-Surgery:
  • Sling use for 3–6 weeks.
  • Limited movement and activities initially.
  • Rehabilitation exercises essential for recovery.

3. SHOULDER ANATOMY

• Glenohumeral Joint (GHJ): Ball and socket joint.
• Labrum: Fibrous cartilage aiding stability.
• Rotator Cuff: Muscle group controlling shoulder movement.

4. SHOULDER CONDITIONS

4.1 Traumatic Instability

• Common Causes: Major injury or repetitive trauma.
• Lesions:
  • Anterior Bankart
  • Posterior Bankart
  • SLAP (Superior Labral Anterior to Posterior)
  • HAGL (Humeral Avulsion of Glenohumeral Ligament)
  • Bony Bankart
  • Hill-Sachs

4.2 Atraumatic Instability

• Cause: Muscle control imbalance leading to joint displacement.

5. ASSESSMENT

Tests

• Standard Tests: MRA, CT scan, EMG, EUA, arthroscopy.
• Diagnosis: Based on symptoms, physical exam, imaging.

Treatment Options

• Surgery is considered for structural damage.
• Atraumatic instability is rarely treated surgically.

6. SURGICAL OPTIONS

6.1 Anterior/Posterior Stabilisation

• Labrum reattached using sutures and bone anchors.

6.2 Laterjet Procedure

• Bone transfer from coracoid to glenoid for additional stability.

6.3 SLAP Repair

• Repair of labrum and LHB tendon using sutures and bone anchors.

7. ANAESTHESIA

• Combination of regional nerve block and light general anaesthesia.
• Benefits include pain relief for up to 24 hours post-surgery.

8. POST-SURGERY GUIDELINES

8.1 Pain Management

• Prescribed pain relief: Paracetamol, NSAIDs, and Codeine.
• Ice packs can reduce swelling (20 min every 2 hrs, avoid direct skin contact).

8.2 Sling Use

• Duration: 2–6 weeks, depending on surgery.
• Remove for hygiene and exercises only.

8.3 Daily Living Activities

• Hygiene: Use safe movements to wash underarm.
• Dressing: Operated arm first when dressing; last when undressing.

8.4 Returning to Activities

• Driving: 3–6 weeks post-surgery, with full arm control.
• Work:
  • Non-manual: 2–4 weeks.
  • Light manual: 6–8 weeks.
  • Heavy manual: 12–18 weeks.
• Sports: 3–6 months, depending on recovery.

9. REHABILITATION

Physiotherapy

• Initial appointment 2–3 weeks post-surgery.
• Exercises reviewed and progressed as needed.

Post-Operative Exercises

1. Neck Mobility: Forward, side-to-side, rotation (4–5 times).
2. Shoulder Blades: Rolling forwards and backwards (4–5 times).
3. Elbow: Bend/straighten, palm up/down (4–5 times).
4. Wrist and Hand: Wrist flexion/extension, finger stretch (4–5 times).
5. Shoulder Passive Movements:
   • Forward Flexion: Lean forward, cradling arms (4–5 times).
   • External Rotation: Use non-operated arm to guide movement (4–5 times).

10. FOLLOW-UP

• Stitches removed at GP after 10 days.
• Outpatient physiotherapy starts at 2–3 weeks.
• Orthopaedic review at 3 months.

11. WHEN TO SEEK ADVICE

Contact the hospital if you experience:

• Fever or temperature.
• Increased pain, redness, or swelling.
• Severe bleeding.
• Persistent numbness after 72 hours.
• Difficulty urinating or issues with painkillers.

12. APPENDIX

• Safe-Zones: Gradual movement from green to red areas.
• Pacing: Frequent, small-duration exercises.
• Soreness Rules: Adjust activity level based on discomfort.

Outcome Questionnaire sent at 1-year post-surgery to assess success and satisfaction.