Shoulder Stabilisation
An arthroscopic shoulder stabilisation is an operation designed to repair the torn ligaments in your shoulder resulting from a dislocation. It is also known as a labral repair. It is a keyhole operation, usually performed under a general anaesthetic. It is usually done through three or four 5-10mm cuts at the back and front of your shoulder.
What does the operation involve?
An arthroscopic shoulder stabilisation is an operation designed to repair the torn ligaments in your shoulder resulting from a dislocation. It is also known as a labral repair. It is a keyhole operation, usually performed under a general anaesthetic. It is usually done through three or four 5-10mm cuts at the back and front of your shoulder. The surgeon inspects the inside of your shoulder and reattaches the torn labrum to the bone using 'suture anchors'. These are essentially plastic plugs with stitches attached, similar to rawlplugs. They are inserted into the bone and the stitches are used to tie the labrum back into place. The operation is usually performed as a daycase procedure, with 90% of people going home within hours of their surgery.
What are the risks and benefits of this operation?
The main benefit of this surgery is to prevent future dislocations. Around 90% of people get some benefit from this operation and many of those report essentially normal shoulders after the recovery period. The risks are in line with the general risks of keyhole shoulder surgery, which you can find more about here.
There are also some specific risks of shoulder stabilisation, which are shown in the video above. These risks include:
- Further dislocations: Around 1 in 10 people may dislocate their shoulder again after recovering from surgery. This is more common in people with more severe damage due to their original dislocation, and particularly in people who do contact sports. It is always helpful to speak to your surgeon about your personal risk of further dislocation. If you do have another dislocation, your surgeon may be able to offer you further surgery to try to stop this form happening. To maximise your chances of a good result, it is very important that you work hard with your physiotherapist after surgery.
- Ongoing feeling of instability: Even if you do not experience full dislocations after surgery, your shoulder may still feel a little 'loose' in certain positions. If this is causing you any problems, please discuss it with your surgeon who may offer you specialised physiotherapy or further surgery to treat this.
What is the recovery after this surgery?
You will be provided with a sling after surgery, along with instructions from the physiotherapist about how to put on and take off the sling. You may be advised to use the sling for only a few days, or up to four weeks. Most people have little or no pain immediately after surgery due to the nerve block that the anaesthetist puts in. It is vitally important that you start taking painkillers supplied to you before the nerve block wears off so that you keep on top of any pain when the block wears off. Some people also find an ice pack helpful in the first few days. You may also find it more comfortable to sleep slightly propped up. It is advisable to get on your feet and walk around frequently to reduce the risk of blood clots in your legs.
Your physiotherapist will give you some exercises to start. It is important that you do these exercises to prevent stiffness and maximise your chance of a good recovery. Most people are allowed to start using their shoulder straight away, within certain limits of movement to protect the repair until it has healed. You will usually be seen in clinic 2-4 weeks after surgery to check that everything is OK. You will notice your shoulder improving over the next few weeks, but it can take several months of work with your physiotherapist to get the full benefit of surgery.
Recovery
Returning to Normal Activities
You can do most general daily activities as you feel comfortable, such as washing and dressing. Try to keep your dressings clean and dry for the first 10 days, and if they do get wet, dry the area and replace them immediately. Avoid over-stretching your shoulder for the first 6 weeks to give the repaired ligaments a chance to heal.
When can I drive?
Most people can return to driving after around 4 weeks or when they feel comfortable. You must not wear a sling to drive.
When can I return to work?
This depends on how heavy your work is. If you work at a desk, this can be as soon as you feel comfortable, perhaps after 2-4 weeks. For heavier jobs, it will take longer. Heavy lifting should be avoided for 3 months. The key is to listen to your body, don't overdo it, and build up to normal activities slowly.
When can I return to sport?
Some sports put more strain on your shoulder than others. Most people return to light exercise in 6 weeks and can then slowly build up to normal activity from there. It is not advisable to return to heavier exercise, overhead sports or contact sports for around 6 months. The key is to listen to your body, don't overdo it, and build up to normal activities slowly.