SHOULDER STABILISATION SURGERY
MELBOURNE

Shoulder Stabilisation Surgery Melbourne

A Patient’s Guide:

 Dr Christopher Pullen – BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

“I may recommend shoulder stabilisation surgery if you have a painful condition that does not respond to nonsurgical treatment including rest, physical therapy, medications and injections.

Prior to recommending surgery, I will undertake a thorough clinical examination, discuss your diagnosis and detail the treatment options to ensure you understand the benefits and potential complications.”

PATIENT CARE PROCESS – DR CHRISTOPHER PULLEN
Dr Pullen’s approach to your care:

1. First Appointment

Referral, consultation & testing.

2. Diagnosis

Diagnosis & treatment options.

3. Treatment Plan

Non-operative VS operative.

4. Follow up & care plan

Monitoring, pain relief & care plan.

SHOULDER JOINT ANATOMY

What are the joints, muscles and ligaments in your shoulder?

The shoulder is made up of three bones:

(1) The Scapula (shoulder blade), (2) Clavicle (collarbone) and; (3) Humerus (upper arm bone)

The shoulder joint is formed where the humerus (upper arm bone) fits into the scapula (shoulder blade), like a ball and socket.

Other important shoulder bones include:

The acromion – The bony projection off the scapula.
The clavicle (collarbone) – This meets the acromion in the acromioclavicular joint.
The coracoid process – The hook-like bony projection from the scapula.

The shoulder has several other important structures including:

The bursa – A small sac of fluid that cushions and protects the tendons of the rotator cuff.
The rotator cuff – A collection of muscles and tendons that surround the shoulder, giving it support and allowing a wide range of motion.
The labrum – A cuff of cartilage that forms a lip for the ball-like head of the humerus to fit into the socket.

The humerus fits relatively loosely into the shoulder joint, allowing the shoulder a wide range of motion.

Shoulder Anatomy

Figure 1

SHOULDER INSTABILITY

Shoulder instability describes a feeling of looseness in the shoulder joint that may result in pain, partial or complete shoulder dislocation

The feeling of instability may indicate that the lining of the shoulder joint (the capsule), ligaments or labrum are stretched, torn or detached, allowing the ball of the shoulder joint (humeral head) to move either partially or completely or out of the socket.

Shoulder instability, if left untreated may lead to shoulder weakness, loss of motion and arthritis of the shoulder joint.

Diagnosing shoulder instability will include a physical exam, X-rays and MRI scan to determine the cause of the instability and to rule out other pathology.

Treatment for shoulder instability includes both non-operative and/or surgical options depending on the individuals circumstances and diagnosis.

SHOULDER STABILISATION SURGERY MELBOURNE

Doctor Pullen will examine your shoulder under anesthesia (usually via arthroscopic surgery) to fully assess the condition of the labrum and rotator cuff tendons to identify the extent and direction of the instability.

In some patients the degree of looseness is mild and the shoulder may be stabilised by arthroscopic techniques.

Severe shoulder instability may require open surgery where an incision is made over the shoulder and the muscles moved aside in order to gain access to the shoulder joint.

The injured structures are then either repaired, reattached or tightened.

The repair is usually performed with sutures attached to metal or plastic anchors.

These anchors are inserted into the bone and hold the sutures that are used to reattach or tighten the ligaments. These anchors stay in the bone permanently.

The surgery usually takes around two hours and has a 6 month rehabilitation and recovery period.

Image – Repair of the glenoid labrum using suture anchors.

AFTER YOUR SHOULDER STABILISATION SURGERY

What happens after surgery?

After surgery you will wake up in recovery room with your shoulder bandaged and in a sling. Dr Pullen will see you to discuss the results of the surgery. Your shoulder will be swollen and painful and you will be given painkillers and an ice pack regime to help ease the pain.

Most patients stay in hospital overnight and go home the next day.

The next morning after your surgery your bandages will be changed and a physiotherapist will see you to discuss exercises and activities you may undertake to help your recovery.

Pain relief – It is normal to have pain after surgery and painkillers will be given to you during your hospital stay and to take home. Your pain will slowly reduce over time.

After your surgery – Do not attempt to lift or rotate the arm. A physiotherapist will discuss the do’s and don’ts and develop a rehabilitation program with you. During the first 6 weeks after the operation it is important that the repaired tissues are not stretched when the shoulder is moved as this risks the repair being torn apart.

An appointment will be organised for you to see Dr Pullen in 10 to 14 days after surgery.

SHOULDER STABILISATION SURGERY – RECOVERY TIMELINE

The recovery period varies from patient to patient and depends on the nature and complexity of the surgery. A typical recovery timeline may include:

Timeline – After surgeryDescription
6 to 8 weeksIt takes at least 6 to 8 weeks for the shoulder tissues to heal. It is important that the repaired tissues are not stretched when the shoulder is moved  during this time so to avoid tearing the repair. The goal is to reduce pain, optimise tissue healing and encourage passive shoulder movement.
8 to 12 weeksRestore shoulder movement to help regain mobility.
4 to 6 monthsIt usually takes between 4 to 6 months after surgery to achieve significant shoulder end range strength, power, and endurance.

Please contact my office or your general practitioner if after surgery you have:

  • Severe pain that is not helped by the pain medication you have been given
  • Redness or swelling around the wounds
  • Fever, sweats or chills.

POTENTIAL COMPLICATIONS

The surgery complications which may occur after shoulder stabilisation surgery include:

  • Shoulder stiffness and restricted movement
  • Infection
  • Numbness or tingling around the shoulder
  • Recurrent tendon tear.

Dr Pullen will discuss with you in detail the potential complications and risks in relation to the surgery.

Mr Troy Keith
Dr Christopher Pullen
BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

If you have any questions please contact my team:

 Shoulder Stabilisation Surgery Melbourne:

Dr Christopher Pullen – Orthopaedic Surgeon

If you have any questions or would like to make an appointment, please feel free to contact my team:

Proud member of Royal Australasian College of Surgeons and Australian Orthopaedic Association.

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Shoulder Stabilisation Surgery Melbourne

Dr Pullen treats patients from all over Victoria in relation to shoulder injuries. He consults with patients at the following practice locations in Melbourne including East Melbourne and Ringwood.