Shoulder

Last updated May 2017

Shoulder arthroscopy is routine. Usually two, but sometimes four or more tiny incisions are needed to let me look from various angles & introduce instruments into the various parts of the joint. The incisions are just big enough to allow a telescope and another instrument into the joint. The telescope is less than 5mm in diameter, but gives me a very good view right around the lining of the joint. The other small incisions lets me do the work with various fine mechanical and motorised instruments.

The wounds I use are too small to have stitches unless a I have to do a lot of work (usually through larger 8-10mm incisions at the front to make room for a tube, which have single sutures) & you wake up with soft dressings and a big bandage. I put some local anaesthetic into the wounds and the joint if the anaesthetist hasn’t numbed the whole arm so that it is a bit numb for some hours after the surgery. You have a sling to support the arm when you wake up.

Following any surgery, the exercises which you are given by the physiotherapist (with a written set of instructions), are very important. If something has been repaired then it is worth resting up until it has had a chance to heal up and take some force. This is usually 4-6 weeks, but during this time, there are some exercises which you can do to stop it getting too stiff. The big bandage can be taken down at about two days and you need to keep the wounds clean and dry until they have healed over in about ten days time when any sutures will need to come out. I usually tell professional rugby league players that after a shoulder stabilisation, they will be out for three months - 4-6 weeks for the ligaments to heal back where they have been stitched, and then another 6 weeks minimum to regain range of motion, strength, but most importantly coordination and proprioception (joint position sense). This is so that the shoulder is used with the muscles working in a coordinated way to minimise the forces on any one area. After a simple decompression, there is still a fairly prolonged rehabilitation period, much longer than following a similar operation in the knee (see rehabilitation).

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