In instabilities of the shoulder joint, a distinction is made between those resulting from accidents after dislocation (traumatic luxation, very common) or constitutional ones caused by weak ligaments (habitual luxation, rare).
Because of the very high risk of repeat luxations and subsequent damage to the shoulder joint, the recommendation is increasingly for early stabilization of the shoulder joint. Open as well as arthroscopic stabilization procedures involving reattachment of the torn labrum and reconstruction of the capsule have achieved outstanding long-term results particularly in comparatively common traumatogenic instabilities.
Habitual luxation (repeated dislocation of the shoulder even after innocuous movements) represents a considerable risk factor in daily life, in the operation of machinery and during sporting activities. For this reason, arthroscopic or open capsular reconstruction (capsular shift according to Neer) is generally the treatment of choice for habitual luxation. In arthroscopic stabilization, this involves inducing shrinkage of the stretched capsule using a holmium laser or modern high-frequency electric devices. The results of this treatment are very promising.
The aim of both arthroscopic and open procedures is to reattach the torn labrum to the socket. In addition to sutures, e.g. connected to anchoring systems, dowels made from reabsorbable material can also been used.
 Arthroscopic labrum repositioning with special suture anchoring systems |
 Reconstructed labrum |
After your operation
You should be admitted as an in-patient for your shoulder operation or at least be placed under extended post-operative care. Arrange to be collected from hospital at the agreed time, because you will not be allowed to drive yourself.
At home, cool the joint several times a day by applying a dry ice-pack for about 15 minutes at a time. As a general rule, your arm will have been immobilized to your body with a bandage; you can remove the bandage at home in accordance with your particular aftercare instructions.
Medication
For about 2 weeks, you should take 1 x 75 mg tablet of Mephadolor® or Voltaren® 2-3 times a day.
Antithrombotic injections
Until full mobilization, continue to inject Fragmin® or Fraxiparin® into the abdominal skin, as you have been shown by nursing staff.
Change of dressing
Dressings are changed 1-2 times a week at your GP's surgery or in our surgery. You can take showers; have your stitches removed after 12-14 days.
Aftercare
Please keep to the stipulated period of immobilization and limited exercise.
Please make sure to keep the check-up appointments agreed with us or other doctors involved in your treatment; recovery after every shoulder operation is different and requires sensitive and consistent aftercare. Do not lose your patience! Even 3-5 weeks after the operation, remaining symptoms are still common, depending on the severity of shoulder degeneration. At regular intervals, we would like to examine you ourselves in our Centre for Orthopaedic Surgery to ensure the best possible recovery process.