Dear,
An arthroscopic stabilization procedure is considered or possible on your shoulder.
It is imperative that you have knowledge of information concerning the operative technique, the consequences and the potential complications (apart from the complications common to any procedure specified in the general information sheet)
Surgical technique:
Your operation will be conducted under arthroscopy (endoscopic camera) to limit the surgical approach, to avoid deltoid insertion and to facilitate immediate protected rehabilitation.
According to the surgeon the position of the patient is either lying on the side (lateral decubitus) or in half-sitting position (beach chair) with a slight traction of the limb to increase the working space (sticky tape on the wrist and the ‘forearm).
Sterile single-use surgical implants are generally used to reinsert the ligaments, bead, joint capsule and / or biceps, they may be metallic or resorbable radiolucent material.
Operative suites:
You return to your room with a temporary immobilization until the first dressing the next day (unless otherwise advised by your surgeon). The definitive immobilization splint will then be put in place and if necessary provided by the Lagarrigue establishments located in the clinic. It may be an abduction cushion (not fully supported by the safety) or a Dujarrier (elbow to the body).
Re-education :
The physio starts at J1 unless otherwise advised by your surgeon in the service and will be continued immediately in town or in a rehabilitation facility. The first month in general the rehabilitation protocol is very limited. The duration of immobilization varies according to the surgeons but never exceeds 6 weeks. A follow-up by your indispensable surgeon will then be scheduled and you agree to respect it when you agree to be operated. The rehabilitation protocol is usually specified on the prescribed prescription or in a booklet that has been given to you.
Complications
Common to any limb surgery
Refer to the general information sheet (cliquez ici)
Linked to the act of anesthesia
Refer to the information sheet (cliquez ici) then to the consultation of preoperative anesthesia
related to your position during the operation:
a stretching of the nerves of the brachial plexus may occur. It has been noted compressions or nerve irritation that can make insensitive or very sensitive part of the upper limb, neck or ear. Often rapid recovery is observed but exceptional sequelae can be observed.
Linked to the surgical act itself:
o An unresponsive or implant migration that can damage the glenohumeral cartilage and sometimes requiring reoperation to remove and strengthen the repair.
o Pain and / or muscle cramps more or less lasting on the biceps after tenotomy or tenodesis of the long biceps if associated gesture.
o Scarring flows sometimes abundant and / or joint infection requiring surgical washing, antibiotic treatment adapted sometimes long and functional damage. Commonly encountered germs are Staphylococcus epidermidis, the propionibacterium acneis which passes from the surface of the skin to the inside of the shoulder. Multidrug-resistant nosocomial infections are exceptional.
o Difficult and lasting consequences in the form of a retractable capsulitis or a dysgraphia that hinder considerably the rehabilitation and the focal recovery of the shoulder, generally in the form of a hyper-painful shoulder then a very severe stiffness.
o Persistence (failure of the operation) or recurrence of instability. Indeed no intervention can guarantee a success rate of 100%, it mainly concerns stabilizations for recurrent dislocation. Regarding arthroscopic stabilization, this rate is currently incompressible by 10% at the very least on the review series of operated patients. The quality of the operation can play, but also the quality of the reintegrated tissues, the non respect of the delay of resumption of the activities at risk (sporting most often). Some patients may experience a new and very violent trauma resulting in a new dislocation as would have occurred on a uninjured shoulder. It is also possible that the shoulder remains troublesome by persistence of a painful instability but does not become more luxury.