Anterior stabilisation of the shoulder
This information will help you gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in conjunction with treatment at UHS.
The shoulder joint is a ball and socket joint. Movement of the shoulder occurs between the ball and socket but also between the shoulder blade and the chest wall (scapulothoracic joint).
The ball and socket joint is designed to give a large range of movement to allow you to move your arm and hand. It has a large ball (head of humerus) and a smaller, shallow socket (glenoid). The advantage of this design is that a very large range of movement at the shoulder is possible, the disadvantage however is that the shoulder can become unstable.
Shoulder stability is controlled by both static (still) and dynamic (moving) factors. The dynamic factors are the muscles around the shoulder, which when in perfect balance greatly help to maintain the stability of the ball and socket joint and prevent dislocation.
The important static factors are:
- the ligaments around the shoulder which help hold the bones together
- the rim of cartilage which helps deepen the socket called the glenoid labrum
- the bones of the ball and socket joint itself.
Following a traumatic injury to the shoulder, the ball may come completely out of the socket and dislocate. Sometimes the ball only partly comes out of the socket and this is known as a subluxation.
Following a traumatic dislocation or subluxation, there may well be damage to the static factors controlling stability in the shoulder. Often there is stretching or tearing of the ligaments and damage to the rim of cartilage on the socket. This may lead to recurrent symptoms of instability, particularly when the arm is lifted upwards and outwards.
If this happens you may need surgery to repair the damage.
X-ray and MRI scans are often used to confirm the diagnosis of structural damage to the shoulder.
About your shoulder stabilisation operation
The aim of the operation is to repair the damage to the structural stabilisers of the shoulder. This involves repair of the damaged rim of cartilage and tightening or repair of the over-stretched and damaged ligaments.
This operation may be done either as an open procedure, where a cut is made over the shoulder or with a keyhole (arthroscopic) technique where smaller cuts are made.
The operation is often performed under a light anaesthetic with a regional nerve block, as a day case. Occasionally you may need to stay in hospital overnight.
Stabilisation surgery of the shoulder is successful in approximately 90% of patients. A small number of patients may have further instability and require more surgery in the future.
Risks and complications
Risks and complications do not happen often, but it is important that you know what they are.
There is a small risk associated with the anaesthetic and nerve block.
There is a small risk of infection, probably less than 1%, a small risk of increased pain and/or stiffness in the shoulder (less than 1%) and very occasionally damage to nerves or blood vessels around the shoulder (less than 1%).