Risks associated with Anterior Stabilisation
All surgical procedures have some element of risk attached.
The risks outlined below are the most common or most significant that have been reported.
Continued dislocation: 10%
If the shoulder does dislocate again it is usually possible to repeat the operation.
Infection: less than 0.1%
If an infection does occur it is usually superficial in the wounds and is easily treated with antibiotics.
Rarely the infection can be deep inside the joint and this requires surgery to wash the joint out.
Nerve damage: less than 0.1%
The axillary nerve runs close to the bottom of the joint and, if damaged causes weakness of the deltoid muscle and difficulty in raising the arm.
The shoulder will often become stiff after surgery and this usually settles with physiotherapy. Rarely the shoulder can become very stiff and require manipulation or arthroscopic release surgery.
General Anaesthetic with an interscalene block (Fully asleep with a local anaesthetic injection into the side of the neck will numb the nerves to the shoulder for post-operative pain relief)
Arthroscopic or open
If the operation is arthroscopic: 3 ½ cm incisions will be made in the shoulder, one to the back and two at the front of the shoulder.
If the operation is “open” arthroscopy may be performed first. The incision for the open operation is a 6cm deltopectoral incision (over the front of the shoulder).
Mobilising the tissues
Inserting the suture
With either type of operation the procedure is essentially the same. The gleno-humeral (shoulder) joint will be inspected first followed by the subacromial bursa and the rotator cuff. The area where the labrum has become detached will be freshened up and the labrum re-attached to the glenoid using 2 or 3 sutures secured to the bone using “suture anchors”
Animation of the Arthrex Pushlock technique for anterior stabilisation
Small butterfly paper stitches will be used to close the wounds. If the open operation has been performed a dissolving stitch under the skin will also be used.
Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.
An immobilser sling will be placed on the arm and it may feel numb for the rest of the day. You can go home when you feel comfortable and will be given instructions on what to do next.