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The Raleigh, Apex, Cary, Garner and Triangle Shoulder Joint Surgery Specialists

Stabilization of The Shoulder By Open Shoulder Stabilization Surgery 

Open shoulder stabilization surgery  is performed as a result of a chronically dislocating joint. With each recurrence of the shoulder dislocation it incurs additional damage that in time can produce arthritic changes. Instability of the shoulder and resulting shoulder pain also significantly affects many normal activities of daily living, especially sporting activities.

Recurring dislocations result in an abnormally stretched capsule and intense shoulder pain. The joint capsule is a static (non-elastic) stabilizer of the gleno-humeral joint. Dislocations of the shoulder may also create additional damage such as tearing of the stabilizing cartilage (labrum) and even the cartilage that lines the surface of the joint.

The aim of this Bankart repair surgery is to tighten, or decrease the size of the stretched capsule as well as repairing any damage to the labrum or articular cartilage.

Open Shoulder Stabilization Surgery 

The Bankart repair procedure entails creating an incision along the crease of the axilla (armpit) and will take anywhere from 1 1/2 - 2 hours. There will be some numbness along the shoulder stabilization surgery incision site that will persist but should not create any problem. Once the skin incision is made, an additional incision is made to open up the joint. At this point, the torn labrum is identified and repaired with a variety of fixation devices. The capsule is then incised and tightened appropriately. This tightening of the capsule will result in decreased movement of the humeral head in the "socket" thus decreasing the incidence of dislocation. There may be some residual stiffness that lasts permanently from the shoulder joint surgery but should not result in many limitations in future activities.
 

Post Shoulder Joint Surgery

After shoulder joint surgery, you will be placed in a sling. You will be given pain medication and ice therapy to reduce the pain and inflammation. A drain will be placed in the shoulder to reduce any inter-joint swelling and bleeding. The first day after shoulder joint surgery you will have the drain removed and you will have a waterproof dressing in place so you may shower. You may remove the sling while showering but will want to take care to leave the arm at your side, avoiding elevation and rotation. Plan to re-apply the sling and wear it at all times. Take additional care to insure that all the skin, especially in the axilla, is dry and even powdered (once the incision site has healed) to risk irritation or infection.

As with any major surgical procedure, you can expect to experience pain after the procedure. You will be given pain medicine and ice therapy to significantly reduce the pain. It is important to use these as recommended to get the maximal benefit.You may also notice swelling in the arm and fingers which will subside over time. You will notice more pain at night and experience difficulty sleeping. Most patients are more comfortable sleeping in a recliner with the arm in a sling and pillows behind the shoulder and upper arm.

You will plan to wear the sling for at least 4 weeks and up to 6 weeks depending on the degree of repair performed .It is not recommended that you drive while wearing the sling or on pain medication. The sling should remain on at all times during this period other than bathing.

You will follow up with your surgeon between 1-2 weeks after surgery. The incision site will be checked, sutures removed and generally insure that everything is according to plan.

Post Operative Rehabilitation

Approximately two weeks after surgery, you will be instructed to begin a protective range of motion program at home and will be under the direction and supervision of a physical therapist. These exercises will be performed within a restricted range of motion and Passive in nature. You will most likely experience pain with your range of motion exercises but if done regularly and correctly, this pain should not be excessive. Approximately 4 weeks after surgery, you will be instructed on active range of motion exercises and later progressing to a resistive program to regain strength. Your physical therapist will guide you through this program appropriately

After approximately 2 -3 months, you should have regained enough range of motion to begin light breastroke swimming. During this time, as comfort allows, you will also be able to start light cardio exercises such as walking briskly, stationary cycling and stairmaster training.

It is highly recommended that you avoid any sporting activities that can undermine the repair during the first 4-6 months after surgery. You may remain active in cardio exercises that do not involve forceful motion of the arm and shoulder during this time. Falling can also risk the healing process during this time..

Approximately 6 months post-operatively, assuming good compliance with your rehab program, you will be released to resume your desired activities. You should plan to maintain good rehabilitation efforts during the 9-12 months after surgery and you may experience residual stiffness during this period. Any slight stiffness that remains permanently should not affect any activities that you should desire to perform.

For those patients desiring to return to high level contact sports, it is recommended that you consider a range limiting brace during the first season after surgery. These braces can be acquired through the office.

It is always important to remember that although the success rate for this procedure is 90%, there is always a chance of recurrence, especially if you participate in higher level contact sports or activities in which you can routinely fall.

For more information on how the shoulder  stabilization surgery specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!

Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC