Arthroscopic anterior shoulder stabilisation surgery
This procedure is the treatment of choice in those who recurrently dislocate shoulder anteriorly (in the front) as a result damage to the anterior capsulolabral structure.
Steps of the Surgery
Arthroscopic surgery is performed through three tiny stab incision of less than 1cm around the shoulder joint. A tubular camera is introduced through one of the stab incision and the joint is visualised. The injuries to the ligaments are delineated and the repair is planned. The retracted ruptured ligament is mobilised so that it can be fixed back to its original position. Often due to the long duration of the pathology the ligaments have lost their normal structure. Special instruments are used to freshen the edges of the bone and also the ligament.
A miniature tubular drill is introduced and a small hole is made into the glenoid bone margin. An absorbable screw with strong fibrewire is anchored into the glenoid margin through the drilled hole. A special miniature device is used to pass the fibre wire through the ligament. The ligament is then approximated to the glenoid labrum and an arthroscopic knot applied to hold the ligament with the glenoid margin tightly. The same procedure is repeated in two or three more places in the glenoid margin so that a tight approximation of the ligament to the glenoid margin is achieved.
Immediately after the procedure, a sling will be given to rest the arm. The movements that can put tension on the repaired structures are prevented for duration of 4 - 6 weeks. Further to that the movements are encouraged. A systematic physiotherapy programme will be initiated to get the full function back.
The Success Rates and the outcomes
The success rate of this surgery is in the range of 90%. The arthroscopic procedure is pretty safe. The pain is minimal as the procedure is done through tiny stab incisions.
Infection, chondral damage, nerve damage is possible complications but the reported incidences are rare.