
SHOULDER SURGERY

	SHOULDER ARTHROSCOPY ARTHROSCOPIC ACROMIOPLASTY ROTATOR CUFF REPAIR TOTAL SHOULDER REPLACEMENT TYPES OF SHOULDER SURGERY
SHOULDER CONDITIONS

	COMPARTMENT SYNDROME SHOULDER ARTHRITIS BURSITIS OF THE SHOULDER SHOULDER TENDONITIS ERB'S PALSY FROZEN SHOULDER SHOULDER FRACTURES ROTATOR CUFF TENDONITIS SHOULDER IMPINGEMENT SHOULDER SPRAINS & STRAINS SHOULDER DISLOCATION
PATIENT RESOURCES

	FREQUENTLY ASKED QUESTIONS BEFORE SHOULDER SURGERY AFTER SHOULDER SURGERY ANATOMY OF THE SHOULDER SHOULDER SURGERY GLOSSARY

Shoulder Surgery FAQs

What is Shoulder Surgery?

There are several different types of shoulder surgery and the recommended procedure depends on the type of problem you are having with your shoulder. Based on a comprehensive evaluation by your doctor, you will usually have a good idea of the diagnosis and the advised procedure prior to starting, but occasionally the doctor will find different or additional damage during the surgery which may change the planned procedure. Your doctor will usually plan on one of the following procedures:

Arthroscopic procedure - a procedure that uses a pen-sized camera inserted into the shoulder through one to seven small holes.
Open procedure - a procedure that uses a two to six-inch incision.

Your doctor may use a combination of the two procedures. Different surgeries require different techniques. In general, your doctor will try to minimize the number and size if incisions used.

Who are candidates for Shoulder Surgery?

Surgery can be suggested by your physician for a variety of shoulder conditions including:

Bursitis - inflammation of a bursa sac which protects and cushions joints
Tendonitis - inflammation of a tendon
Damaged shoulder cartilage
Torn labrum - a labrum is a special type of rubbery cartilage in the shoulder.
Impingement - where bone in the shoulder rubs on the rotator cuff muscles.
Instability - where the shoulder dislocates or has too much motion.
Fractured Collarbone
Acromial-Clavicular (AC) Separation - a condition in which the main part of the shoulder is torn loose from its attachment on the collarbone.
Fractures involving the upper part of the Humerus Bone (the upper arm bone).
Shoulder Arthritis
Rotator cuff tears - either partial or full thickness tears of the rotator cuff, the group of four small muscles wrapped around the shoulder joint deep under the skin.

The outcomes of both arthroscopic and open surgery are good depending on the type of surgery done inside the surgery.

What are alternatives to Shoulder Surgery?

Most shoulder injuries are treated initially without surgery. Your doctor can help guide you in selecting the right treatment for you and your particular problem. Your doctor will often suggest some combination of non-surgical treatments including:

Pills, especially non-steroidal anti-inflammatory dugs (NSAIDs), pain pills, muscle relaxants, etc.
Physical therapy
Injections directly into the shoulder (usually steroids)
Activity modification (avoidance of activities that cause symptoms)
Additional tests such as x-rays and/or an Magnetic Resonance Imaging (MRI) scan

Non-surgical treatments are advantageous because you avoid the risk of infection and reactions to anesthesia. They also can result in the resolution of symptoms within a few weeks to a few months of beginning treatment. For example, non-surgical management of rotator cuff tears can provide relief in approximately 50 percent of patients. In general, if your shoulder problems last more than six months, you should be evaluated by an orthopedic surgeon to discuss additional treatments including surgery.

How do you prepare for Shoulder Surgery?

Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.

Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:

Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

What is the Shoulder Surgery recovery process?

In most cases, you will be able to return home on the day of the procedure. You will need a companion to drive you home, particularly if general anesthesia has been used. In some cases, an overnight hospital stay will be required.

Incision care- if an arthroscope is used the incisions are usually so small that they may not even need sutures. Procedures requiring bigger incisions will usually be closed with sutures or staples. Dressings are usually light and are kept on for a couple of days. Drainage may occur from the wounds during the first day and usually stops within the first 24 hours.
Shoulder immobility - your shoulder will usually be held in a sling, a sling and swath, or a brace following the surgery. The amount of movement allowed following surgery will depend on the procedure that was performed. Your doctor will advise you as to what movements are allowed during recovery.
Ice and Medication - you will be encouraged to use ice to control pain and swelling. Follow your surgeon's instructions carefully, but in general you should plan to apply ice for about 20 minutes on and 20 minutes off for most of the first 2-3 days after surgery. Ice should not be placed directly onto the skin. Place a moist towel on the skin and apply ice in a plastic bag directly over the towel. Medication will also be prescribed for pain in the form of pills or injections.
Follow-Up - depending on your condition, you should schedule multiple follow-up appointments with your doctor to ensure your recovery is progressing well. Your doctor may recommend that you seek help from a physical therapist who will teach you a series of exercises that will help you regain your strength and range of motion in your shoulder.

What is the cost of Shoulder Surgery?

A variety of factors may influence the cost of the surgery. They include:

Insurance coverage
Pre-existing health
Insurance co-pay
Location of the facility

These factors vary depending on you and your situation. The cost of each procedure can vary dramatically based upon age, location, gender, and insurance coverage. A detailed cost estimate for Shoulder Surgery should include:

Muscle transfer to one or more shoulder areas
Scapula repair
Cutting one or more tendons to lengthen a muscle
Rotator cuff repair within or after one month of injury
Shoulder ligament release
Repair of torn tendons
Repair, removal or transplant of bicep tendon
Repair shoulder capsule by reattaching tendon or ligament to shoulder socket, to limit motion, or correct instability, may also involve transferring cartilage (coracoid)
Replacement of all or part of shoulder joint with an artificial implant
Repair of the collarbone (clavicle) with or without bone graft, pins, plates or wires
and Repair of the upper arm bone (humerus) with pins, plates or wires.