Just had major reconstructive surgery for anterior instability

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Topic Title: Just had major reconstructive surgery for anterior instability
Created On: 12/29/2008 05:34 PM

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 02/03/2009 07:56 PM

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seattlesetters

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Had my 6-week post-op today. I'm doing well, but the joint is a bit tight for this long after surgery. My OS wants me to step up ROM work and has given my PT the green light for full ROM excercises. The doc explained that I had A LOT of work done and any one procedure may not leave me so stiff but the combination of things has made it tough to get limber. He says I'm not too far behind schedule and I should be able to catch up in a couple of weeks with the more aggressive RMO therapy. It'll still be passive, however, and I'm restricted from strengthening for four more weeks. That bicep of mine is going to turn to jelly!I do have a rather nasty blod clot at the bottom (insertion at humerus) of my anterior deltoid that is somewhat impeding my progress because it is very tender to the touch (it's a huge "knot" of blood and scar tissue) and lights up pretty good if that muscle gets stretched. My PT will bombard it with ultrasound to help break it up.I'm glad he's now allowing me to lift up to five pounds (not in a "workout" situation, but only if necessary and without any dynamic motion) so at least I can help a bit more around the house.All-in-all, a good checkup. The joint itself feels good...nice and smooth when the PT stretches it out. As soon as I can fight through this stiffness, I'll be well on my way to a happy shoulder.


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 01/26/2009 05:12 PM

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seattlesetters

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Update: I am now five weeks post-op. Of course most of the localized pain associated with surgery is gone. The shoulder is still quite tender, though, and I experience what can mostly be described as a "dull ache" in most of the joint with some sharper pains in the anterior deltoid (split during surgery) and in the entire biceps muscle. In fact, most of the pain I have at this point is from those two areas.Rehab is going well. I can extend my arm about 120 degress straight out and can externally rotate about 20 degrees. I am not allowed to raise my arm laterally or behind me just yet, but these things will come. I'm also on a one-pound lifting restriction for another three weeks, so range of motion excercises are all I'm able to do at this point.The swelling around the clavicle from the resection is nearly gone as is all bruising. The incisions seem to be healing OK. I do get cramps in the relocated biceps on occasion, but other than that, I have no complaints. I know it is a slow process and my shoulder will not work as it should for some time. I am taking a total, long-term approach and am working toward a complete and successful rehab within the parameters set by my care team.In talking with surgeon at a follow up, I learned he also had to repair the subscapularis tendon...that makes two RC repairs with this procedure. He told me he used a 7mm, bio-absorbable interference screw placed into a hole pre-drilled in the humerus for reattaching the long head biceps tendon. The screw, made from advanced polymers and bio-engineered materials, should become mostly bone in about two years.
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 12/30/2008 09:57 AM

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JuliePC

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Please share your elbow experiences with me. I am post op 1 week right elbow joint surgery. Also had lateral epicondylitis repair a year ago. Will this ever be good?? Thanks, Julie
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 12/29/2008 07:01 PM

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seattlesetters

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Hi Julie - Thanks for replying! Thanks for the tip on the scar tissue. I've had five surgeries now (two right elbow, two right shoulder and one ACD at C5-6. I am not the great scar tissue creator that you are (thank Heaven!) but I'll be on the lookout for symptoms, nonetheless. I KNEW there was a reason I felt good about getting away with a tightening without anchors. Perhaps this is it.I live in Bellevue just across Lake Washington from Seattle. I absolutely love it up here, and can see how you would miss it.
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 12/29/2008 06:28 PM

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JuliePC

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seattlesetters,I think you and i had surgery on the same day - - Dec. 22nd, I went in for my 6th surgery! I've now had 3 right shoulder, 1 left shoulder, and now 2 elbow surgeries. 3 of my surgeries were w/in the last 6 months and and all were w/in the last 2 years!Although I'm not familiar with all that you had done....the one thing that comes to my mind is to be very aware of scar tissue that might form, causing stiffening and possibly adhesive capsulitis. I'm not saying that is going to happen, but it sure did for me. I am a GREAT scar tissue creator and it consistently gets me into more trouble. So just beware!! Not fun to deal with!!!!Very glad you are off the narcotic pain killers. I am too...although might need it tonight since I started PT again today.Always nice to be lucid!!I've had 2 SAD's and repairs of torn labrum and RC....nothing with biceps (yet).I also had a loose capsule, which was tightened in my first surgery. Interesting to note that anchors were used to tighten it. They later formed scar tissue and started grooving my humerus bone! (as was discovered in #4 surgery!). Maybe better without anchors!Hang in there. Oh, I like your screen name. Are you from Seattle? I lived in Seattle and Portland, OR for 23 years and am now living in New England. I do miss the Seattle area however.Take care and keep posting. Julie
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 12/29/2008 05:34 PM

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seattlesetters

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I'm new here but thought this would be a good way to track my progress and get feedback from others who've experienced the same type of surgery I had last Monday (I'm now exactly one week out). For background, I had a full anterior dislocation many years ago that was reduced manually. I had surgery in 1994 to reduce an impingement. The surgeon performed acromioplasty (SAD) with a minor rotator cuff repair and removal of the bursa sac. This really didn't correct the problem (which was a loose capsule due to the dislocation) and I've lived with anterior subluxation ever since. Well, I finally got sick of not being able to do overhead things comfortably and when I had to sit out a couple of days of fly fishing during my summer vacation this year due to pain, I knew the time had come.After taking a history and ordering an MRI, the surgeon felt after a physical examination he could help me but that I'd need a lot of work. He gave me the option of having it done all at once (his recommendation) or spreading it out over the course of three procedures. Since I'd had shoulder surgery before, I wasn't exactly anxious to have it done three more times, so I went with his suggestion.On Monday, he performed a distal clavicle resection, anterior capsular plication via Bankhart revision and biceps tenodesis of the long head, using an open procedure and a 7mm, bio-absorbable interference screw placed into a hole pre-drilled in the humerus for reattaching the long head biceps tendon. The screw, made from advanced polymers and bio-engineered materials, should become mostly bone in about two years. There was also some general "house cleaning" with debridement of the coracoacromial ligament, repair of partial-thickness tears of the supraspinatus and subscapularis tendons and clearing of bone spurs from what's left of the acromion.There are four incisions...three for the scope and one open (approx. 2") for the repositioning of the biceps tendon. The capsule was tightened with a "nip & tuck" into the labrum with a Bankhart revision rather than a full detachment with anchors. I don't exactly know why, but I'm glad it worked out that way. He also had to split the anterior deltoid muscle (ouch!) in order to get the long head of the biceps tendon out of its sheath, so I realize I'll need extra recovery time for that large muscle to heal.I'm now firmly past the "Please just shoot me an put me out of misery!" stage. In fact, I've been completely off narcotics for two full days. However, it now feels as if I have indeed been shot if I happen to move my arm or if it gets bumped. I know that will go away soon, but it still is very uncomfortable.My first PT appointment is this Wednesday. I've been to this PT before and she is outstanding. She'll get me up & running in no time (maybe not throwing a fastball just yet).I'll report back as my recovery progresses. If any of you have questions or words of encouragement, please feel free to post. Thanks!


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