Shoulder stabilisation / Labral repair
The nature of shoulder instability is complex and any treatment or operation will always be tailored to the patient’s pathology. However, most stabilisation procedures will usually involve an arthroscopic procedure in which a torn labrum is either repaired back to the glenoid (socket) rim or alternatively, lax capsular tissue is tightened or plicated. The effect of these procedures is to provide greater security to the shoulder joint so that shoulder stability is restored.
An arthroscopic stabilisation is performed as a ‘key-hole’ procedure through 3 or 4 small incisions. Small ‘anchors’ are used to secure suture material into the bony rim of the glenoid. Attached to these anchors are sutures (threads), which are then used to repair the torn tissue or alternatively, tighten any lax tissue. By doing so, stability can be improved however time is needed for the repairs to heal and therefore a sling or brace is needed to support the shoulder for 4-6 weeks thereafter.
Information for patients / operative Information
Risks and complications
- Nerve injury
- Recurrent instability
- Degenerative change
- Please bring any X-rays or scans with you to the hospital. This will usually be on a CD disc. These will not be needed if it was Mr Falworth who organised the investigations.
- No food for 6 hours, or drink for 4 hours, prior to surgery.
- Please avoid smoking for 12 hours prior to surgery
- A shoulder stabilisation is usually performed as a day case or as a single overnight stay.
- Three to four incisions, each approximately 1 cm in length, are made around the shoulder. These are closed with Steri-strips and/or dissolving sutures.
- Splash proof dressings will be applied but the wound should remain dry for 10 days.
- Prior to your discharge from hospital, a physiotherapist will demonstrate some simple exercises as part of your rehabilitation protocol. These exercises should be undertaken when you’re at home and will help your shoulder recover from the surgery before your outpatient physiotherapy commences.
What to Expect
- Swelling; immediately after an arthroscopic procedure there can be quite a lot of swelling around the shoulder but this settles after approximately 24 hours. A Cryocuff or alternative cold therapy compress, can be helpful in minimising swelling and inflammation. The Cryocuff will usually be issued to you upon discharge
- Pain; an Interscalene Block is often used to reduce immediate post-operative pain. If any discomfort arises once the block has worn off, simple oral analgesics can be taken to manage this. These will be provided to you upon discharge.
- Bleeding; there may be some oozing through the bandages but this should settle soon after the operation.
- A sling or brace will be provided to help rest the shoulder. This must be worn for 4-6 weeks after the surgery as deemed appropriate following the operative findings. For stabilisation surgery, depending on the type of sling that has been provided for you, the belt that helps secure the sling should be worn for 4-6 weeks,
- The wound should be kept dry for 10 days.
- At ten days the dressing and paper Steristrips can be gently removed. If the wound is ‘dry’ then it is all right to wash the wound. If not, please consult Mr Falworth or your GP for further advice.
- The most important part of your post-operative care is to start an early exercise programme, which the ward physiotherapist will have commenced prior to discharge from hospital. This will maximise the benefit of your operation and will continue as an out-patient.
- You will be reviewed in clinic approximately 3 weeks following your surgery.
Estimated return to functional activities
- Driving 7-8 weeks
- Light duties 7-8 weeks
- Return to work Usually 2 weeks but depends on occupation
- Heavy Lifting 12+ weeks
- Repetitive overhead activity/sport 18 - 25 weeks