Stabilisation of the shoulder

This leaflet will advise you on having a shoulder stabilisation and outline the recovery of your shoulder following the surgery. 

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Why do I need this operation 

Your shoulder is a ball-and-socket joint made up from the head of your arm bone (humerus) and shoulder socket (glenoid) which is part of the shoulder blade. Dislocation of the shoulder damages the ligaments. In some patients the ligaments do not heal well and the shoulder remains "unstable" meaning it is easier for it to partially or fully dislocate. 

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The operation 

The aim of the operation is to repair a ring of cartilage (glenoid labrum) around the socket. This has been pulled off during a shoulder dislocation. This will increase stability by deepening the socket of the shoulder joint and tighten the ligaments and capsule to minimise the risk of further dislocation. This will usually be a keyhole procedure (known as arthroscopy). During the operation the surgeon will re-attach the labrum and tighten the ligaments using small "anchors" - these are small hard pellets (usually plastic) with tails of strong suture material (stitches) that are inserted into the bone at the edge of the socket. The suture tails are used to fasten the soft tissue back into place. This procedure is usually done by keyhole (arthroscopic) surgery. 

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Potential complications 

Even when an operation goes well and achieves what it meant to do, there are a small proportion of patients (about 5%) who do not improve following surgery. Unfortunately any operation has a chance of having a complication. Fortunately the chance of having a complication is small (<5%) and having a significant complication that will have a negative effect on the outcome of surgery is even smaller (<1%). The following are specific complications associated with an anterior stabilisation: 

Re-dislocation this is probably the most common complication with this procedure. Even with an excellent surgical repair it is not possible to restore your shoulder to its pre-injury stability. After recovery and appropriate rehabilitation you can return to sports as you wish but you will be at risk of re-dislocation especially if you partake in contact, overhead or competition level sports. 

Stiffness a degree of stiffness is expected and desired after this operation as the process of stabilising the joint involves tightening it up. You will regain a full functional range of movement between 3 and 6 months after surgery although you may have a permanent loss of external rotation but you are unlikely to be aware of this. Sometimes stiffness can be severe and take longer to resolve. It may be up to a year for normal movement to come back - this is called a "frozen shoulder". 

Arthritis as soon as the shoulder has dislocated there is damage to the cartilage covering the joint. To a degree the amount of cartilage damage is proportionate to number of times the joint has been dislocated. Although the procedure will stabilise the shoulder it cannot heal the cartilage or necessarily prevent its progression. It may be that once the shoulder is stabilised the cartilage will not progress to arthritis but some cases it will and eventually require a shoulder replacement but this may be after many years and only in rare cases. 

Infection superficial wound infections are more common and can often be treated with a short course of antibiotics. Deep infections within the joint are rare but would require you to come into hospital to have the shoulder washed out and go on intravenous antibiotics 

Nerve injury this is unlikely to occur as the ports made for the keyhole surgery are place away from the known position of nerves. Sometimes nerves can get compressed or squashed during surgery which will present with numbness and weakness but this is likely to resolve within a few weeks. 

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The shoulder joint after surgery 

Hospital stay: Normally done as a day case 

Arm immobilisation: Sling or brace (see image) for 4 weeks 

Total recovery period: 6 to 9 months 

Return to driving: 6 to 8 weeks 

Return to work: Desk based job - 2 to 4 weeks Manual job - 3 months 

Return to sports: Non-contact from 4 months Contact/overhead from 6-8 months 

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