Shoulder Surgery Complications

The most flexible joint in the body, the shoulder is responsible for raising, lowering, and rotating the arms into any number of positions. Yet this same flexibility makes it susceptible to almost as many injuries, either through trauma or routine wear and tear. Many shoulder injuries can be treated with nonsurgical means, but delaying surgery too long can result in lingering discomfort or even permanent disability. While complications are rare in shoulder surgery, they can happen.

Facts

• The shoulder is a ball-and-socket joint, which is why it has such a wide range of motion. The ball at the top of the arm bone fits into the grooved socket of the shoulder blade. The clavicle is the third and final structural component of the shoulder joint, and it connects the shoulder blade to the breastbone, providing stability and support. The soft tissue surrounding the shoulder joint is called the labrum. This can often become torn, requiring surgical repair. Another cause for concern is the muscles and tendons connecting the upper arm to the shoulder blade. Known as the rotator cuff, these connecting tissues are responsible for lifting the arm and reaching overhead.

Considerations

• There are two main types of shoulder surgeries. The easiest, less invasive procedures are arthroscopic, which require only small incisions through which the doctor inserts a thin device called an arthroscope. No larger than an ordinary drinking straw, the arthroscope is a flexible fiber optic scope equipped with a tiny camera, light source and surgical tools. The surgeon can use it to explore the damaged area and perform the operation without ever having to completely open the shoulder. In contrast, open surgical procedures require slightly larger incisions, usually a few inches long, so the surgeon can directly see and manipulate the area.

Time Frame

• The type of surgery performed, whether arthroscopic or open surgery, has little to do with recovery time. Rather, healing and rehabilitation depends entirely on the repairs done to the shoulder.

Types

• The types of complications one can encounter after shoulder surgery depend on the procedure performed, although the most common concern is damage to the surrounding nerves and blood vessels. Nerve problems, often due to pressure during the operation, occur in roughly 1 to 2 percent of all patients, with the effects lingering anywhere from two days to six weeks. Symptoms include tingling and numbness in the extremity. It's normal for the surgical wounds to bleed somewhat following surgery, but excessive or unusual bleeding could be the sign of blood vessel damage and should be reported immediately.

  During rotator cuff procedures, bone screws may be used to reattach torn muscles and tendons. These screws can become loose and cause irritation, ultimately requiring surgical removal. Of course, there's always the risk of infection with any surgery. Swelling, redness, warmth and tenderness can all be signs of infection. Treatment is typically done with either oral or injected antibiotics, although surgery could be required in rare instances.

Prevention

• The best way to prevent complications from shoulder surgery is to fully comply with the orthopedic surgeon's aftercare instructions. Keep the wound clean to promote healing and institute a daily stretching and strengthening program to recover full range of motion.