There are two broad categories of shoulder surgeries:
- Open surgery – where the usual long skin incisions are made to allow approach to the shoulder joint for the surgery to be carried out. Examples are open reduction and internal fixation of fractures of the shoulder (humeral head fractures, glenoid fractures).
- Arthroscopic surgery – where the surgery is done via tiny keyhole incisions and a camera is placed inside the joint to allow the surgeon to see inside the joint and to perform the surgery. Examples are arthroscopic rotator cuff tendon repairs.
Shoulder Surgery Procedure
Over 95% of the conditions that I treat involving the shoulder joint can be done via arthroscopic approach. This is a minimally invasive procedure that can at times lead to less pain and faster recovery for the patient.
Most of my shoulder surgeries are done in the hospital under general anaesthesia. I will usually request my anaesthetist to perform a nerve block so that the patient has no pain during and for a period of time after the surgery.
This helps to reduce the need for oral pain killers that sometimes can result in nausea and vomiting.
Most forms of keyhole shoulder surgeries will necessitate the patient to use a shoulder sling for about 2 days post-surgery to rest the shoulder joint.
What to Expect Post Shoulder Surgery
For those that had undergone shoulder rotator cuff tendon tears, they will need to avoid excessive active movements of the operated shoulder as it takes about 6 weeks for the repaired tendon to mend back to the bone of the humeral head. These patients will be taught a passive range of motion exercises for the first 6 weeks. They start an active range of motions of the operated shoulder from the 7th week onwards.
Most patients tell me that the operated shoulder is most painful at night and for the initial 2 to 3 nights after the surgery. There is usually minimal pain in the daytime. Most of these pains can be well controlled with simple medications.
Patients will also need to undergo physiotherapy of their shoulders. These can be started soon after surgery for certain conditions and at the 7th weeks onwards for patients with cuff tendon repairs.
Consult with your orthopaedic surgeon to get more information.
