Shoulder stabilisation success
NORMALLY, the shoulder has a wide range of motion, making it the most mobile joint in the body. Due to this flexibility, however, it is not very stable, is easily injured, especially in contact sports, and can deteriorate with constant use over time. Where appropriate, the Latarjet stabilisation procedure is used, which has a very high success rate.
Mr Rhys Williams, a senior orthopaedic surgeon specialising in shoulder and knee surgery, who practises privately at the Nuffield Health Cardiff & Vale Hospitals and in the NHS at the University Hospitals of Wales and Llandough in Cardiff, is well-placed to explain about shoulder stabilisation, which he has been performing for many years.
Mr Williams explained: “Basically, the shoulder is a girdle with lots of muscles which need to function in a co-ordinated manner. It is important to take ageing and the person’s occupation and lifestyle into account when making the diagnosis. As tendons age, they are less able to tolerate stress, are less elastic and are easier to tear. Shoulder instability happens most often in young people and athletes. When muscles and ligaments that hold it together are stretched beyond their normal limits, the shoulder becomes unstable.
“I’ve been doing shoulder stabilisation operations for 20 years and in appropriate cases have always done the Latarjet procedure. It should be the operation of choice in patients with bone loss, failed keyhole surgery and, more recently, has become the right choice in collision of sportsmen and women.
“Whereas arthroscopic (keyhole) surgery in collision sports like rugby carries a failure rate up to 15%, in the last three to five years it’s become more common to choose a Latarjet open surgical procedure which carries a failure rate of below 3%.
“In brief, the operation has three parts which are essential for optimum results. The ligaments and soft-tissue socket edge are restored by pretensioning and repair, as in keyhole techniques. Then the socket is augmented with a bone block taken from another part of the shoulderblade. Finally the tendon that is attached to that bone block is used to provide a muscle sling at the front of the shoulder.
“The operation takes an hour to do, the patient is in a sling for six weeks and total rehabilitation time is 16-20 weeks for a return to full sport.
“Physio starts even in the sling but full rehab commences when the sling comes off and continues for about three to four months in total. There are patients from as far as Hong Kong who have come to Nuffield Health in Cardiff for this surgery.”
To find out more about shoulder surgery at Nuffield Health, please ring 01443 449251 or for a free event on shoulder surgery on the evening of Monday, October 22, book online: www.nuffieldhealth.com/ hospitals/cardiff-and-vale/events
Consultant orthopaedic surgeon Mr Rhys Williams, who specialises in knee and shoulder surgery at Nuffield Health