The shoulder is made up of a socket and ball joint. Basically the humerus, scapula and collarbone also play an intricate part in the overall make-up of the shoulder. The ball on the top end of the arm fits into the socket of the shoulder blade and forms the shoulder joint, this is then surrounded by a soft tissue rim. Cartilage on the head of the arm bone and a thin lining of the joint allows the smooth motion of the shoulder. The collarbone is joined to the shoulder blade by the AC joint. The other end of the collarbone is attached to the breastbone or sternum. Fibers surround the shoulder joint and allow for a wide range of motion plus they provide stability. A rotator cuff is a group of muscles and tendons that attach the upper portion of the arm to the shoulder blade. The rotator cuff covers the joint and fibers surrounding the joint. The muscles known as the rotator cuff allow you to lift, reach, throw, etc. The bursa or sac membrane between the rotator cuff and the shoulder blade cushions and helps lubricate the two structures.
There are two types of surgical procedures that a doctor may suggest for shoulder problems, both surgeries depend on the problem at issue. However the most common procedure done on the shoulder is the “Arthroscopy”, which allows the orthopedic surgeon to insert a device with a small lens and a light into tiny incisions to look inside the joint. The pictures are then relayed to a monitor which allows the doctor to make a diagnosis. Other instruments can then be inserted to make the necessary repairs, based on the problem. Arthroscopy for the most part is an outpatient procedure and one can be able to return home the same day as the surgery. Here is some further information on the care of arthroscopic shoulder surgery.
1. Incision Care – The incisions are small, so they typically do not require sutures. Dressings are usually light and are kept on for only a short time. Dressings should be kept clean and dry. Some drainage may occur that first day and this is normal, but call your physician if you have any questions. It usually is scant and stops within a short time.
2 Shoulder mobility or should I say lack of – The movement allowed following surgery depends on the procedure that is performed and your doctor will instruct you on what you will or will not be able to do after surgery. Typically following rotator cuff surgery, shoulder movements will not be allowed for a period of time. The shoulder will be in some type of immobilization device following the surgery that prevents this.
3. Ice – Some doctors will typically recommend ice being applied to the shoulder to control pain and swelling. Excessive swelling makes the pain worse and sometimes increases scarring, which makes the shoulder stiff in the joint. You will probably be instructed to apply ice about 3 times a day. Do not apply ice directly on the skin. You can use a moist towel over the skin with the ice in a plastic bag directly over the towel, plus now they have ice bags that are covered in material.
4. Medication- Your doctor will prescribe something for pain and typically this medication will be in pill form. If you do stay in the hospital overnight you may be given your pain medication by injection or through a pump in which you will receive a controlled dosage when you need it, at the push of a button. Sometimes your physician may also prescribe antibiotics that may ward off infection and help lead to a faster recovery.
5. Avoid cigarettes- Your physician will also urge you not to smoke if your a smoker since this hinders the recovery (healing) process.
Before leaving the hospital after surgery a follow-up visit will be scheduled within one to two weeks to assure that your wounds are healing properly. Another visit will be most likely be scheduled for 4 weeks after that to make sure that the therapy is showing progress. Follow-up visits after that will most likely be about three and six months so that the doctor can check on your progress and do follow-up x-rays to check on the joint healing process.
Complications following arthroscopy are almost unheard of, however contact your doctor if any of these problems arise.
Drainage continues more than one day after the surgery or a foul odor develops from the wound.
The wound shows redness or an extreme amount of swelling, especially if any streaking is noted.
Pain is not controlled with the medicine the doctor has prescribed.
Your temperature goes up to above 101° degrees, or if you notice extreme heat in one section of the arm along with swelling.
Any kind of nausea or vomiting that has come about since taking the medication prescribed. Contact your physician just in case you may be having a reaction.
After the surgery the doctor will give you a list of instructions to follow and you will also be instructed to begin a course of physical therapy for rehabilitation. Rehab is the most important part of treatment for a full recovery.
Open Surgery – is another medical procedure that maybe necessary under certain situations and may under certain situations give better results than arthroscopy. Open surgery can be done through small incisions of just a few inches. Recovery and rehabilitation is not dependent on what type of surgery that is chosen but what type of surgical procedures are performed inside the shoulder, so therefore there is usually no difference in the instructions given from your physician.
As always there are risks with any surgery, even with shoulder surgery. These include infection, damage to nerves or blood vessels. However your physician will monitor you closely to minimize any problems that may arise. After surgery it is normal to have some pain and stiffness, however you should report to your doctor any problems you may have immediately and you physician is there to answer any questions you may have prior and after your surgery.
References for this article include: Web MD and Orthopedics.about.com
