What are the RISKS associated with shoulder surgery?
As with any surgery, there are potential risks involved in frozen shoulder surgery.
It is important that you are informed of these risks before the urgery takes place.
Complications specific to the shoulder can be surgical or medical.
Wound Irritation or Breakdown
The operation will involve cutting some skin nerves, so the patient can expect to experience some numbness around the wound. This should not affect the function or use of the joint. There may also be some pain or tenderness around the scar. On occasion, the patient may react to the sutures and require antibiotics or rarely, further surgery.
Blood Clots (Deep Venous Thrombosis)
These can occur in the calf muscles and can travel to the lung known as a pulmonary embolism. Occasionally they can be serious and even life threatening. If you get calf pain or shortness of breath at any stage, you should notify your doctor or go directly to the Emergency Room.
Stiffness in the Shoulder
Frozen shoulder surgery is performed to increase motion. However, although scar tissue is removed, it can easily reform. Physical therapy is essential after surgical treatment for frozen shoulder; the surgery will not work without it. Even with aggressive PT, stiffness can recur. Sometimes a second manipulation under anesthesia or injection is required.
There may be some post-operative numbness or tingling of the arm or hand
Infection can occur with any operation. If so, it can be treated with antibiotics or there may be a requirement for further surgery.
In some rare cases, surgery for a stiff frozen shoulder can result in shoulder instability.
General Medical Complications
Medical complications relate to the anesthetic and the patientís well being. With this surgery, the most common would be;
- Allergic reactions to medications
- Complications from nerve blocks such as infection or nerve damage
Before Surgery... make sure you ask your Doctor these questions!
According to advice given by the American Academy of Orthopaedic Surgeons, we have listed below the questions that you should ask your doctor before proceeding to undergo surgery:
- Why is this procedure being recommended? Are there alternatives?
- What are the benefits of this procedure in terms of pain relief, functioning/mobility? How long will the benefit last?
- What are the risks involved?
- What is the success rate for this procedure?
- What is the procedure called? How is it done?
- Will this surgery solve the problem? Will any more surgery be required in the future?
- How many of these procedures are annually performed at this hospital?
- What percentage of patients improve following the procedure?
- What will happen if I don't have the surgery now?
- If I want a second opinion, whom can I consult?
- Will my doctor perform the operation or someone else? If someone else, when can I meet him or her?
Is the doctor board-certified?
- How many similar procedures have been done by my doctor (or whoever will perform the procedure?) What are the outcomes?
- Will I need any tests or medical evaluations prior to the surgery?
- What kind of anesthesia will be used? Are there ossible after effects or risks? Will I meet with the anesthesiologist in advance? Will her or she know my needs/allergies?
- Will I have pain following the procedure? What pain relief or pain control measures will I be given?
- How long will the recovery take? What are my limitations during recovery? Will I need assistance at home afterwards? For how long? What will discharge instructions be?
- Will I have any disability following surgery? Will I need physical therapy?
- When can I return to work? When can I drive my car?When can I have sexual activity?
- Are there any written materials or videotapes about this surgery that I can review?
Shoulder surgery is usually the last resort. We take a look at whatís involved and answer your most frequently asked questions
There are a number of techniques used by practitioners to try to relieve the painful and debilitating symptoms of frozen shoulder including therapy and anti-inflammatory medicines. Surgery for frozen shoulder is usually considered only after a concerted effort at all other conservative treatments, have failed. In other words, it is a last resort.
There is no discrete timeline to proceed to surgery. As a general rule you should have participated in some form of therapy for a minimum of 4 to 6 months and shown little or no progress. If, after this time, you are still having trouble working, with your day to day activities and/or sleeping, you may be advised to consider surgical intervention. In these extreme cases you would be referred to an Orthopedic surgeon (a specialist in conditions that affect the bones and joints) to discuss the option of surgery.
It is important when you meet with the Orthopedic surgeon, to discuss in detail about the operation, your potential for recovery and the risks involved with surgery.
The goal of surgery for frozen shoulder is to stretch and release the stiffened joint capsule. The most common methods include Manipulation Under Anesthesia and Shoulder Arthroscopy.
Manipulation Under Anesthesia
During this procedure, you are given a general anesthetic - a painkilling medication that puts you to sleep. The surgeon will force the shoulder to move which in turn causes the capsule and scar tissue to stretch or tear. This releases the tightening and should increase the range of motion. In addition to this
surgery, you will usually have corticosteroid and local anesthetic injected into your shoulder joint.
Manipulation in this way is not without its disadvantages. There is a small risk of humeral fracture, labral tears, rotator cuff injuries, dislocation, and brachial plexus injury.
Arthroscopic capsular release is an alternative procedure to manipulation.
Whilst under a general anesthetic, the surgeon will cut through tight portions of the joint capsule. This is done with keyhole surgery using a special probe which is inserted through small incisions around the shoulder to open up the contracted shoulder capsule. He will then remove any bands of scar tissue that have formed in the shoulder capsule, which should improve the symptoms.
In many cases, both manipulation and arthroscopy are used together to obtain the best results. Most patients have good outcomes with these procedures.
After surgery, you will have to undergo a course of physical therapy to maintain the motion that was achieved with surgery.
Recovery times vary, from six weeks to four months. Although it is a slow process, your commitment to therapy is the most important factor in returning to your normal daily routine.
The long-term results from surgery are generally good, with most patients having reduced or no pain and greatly improved range of motion. In some cases, however, even after several years, the motion does not return completely and a small amount of stiffness remains.