Question:My hotshot basketball playing son tore his rotator cuff and the labrum of his shoulder. After a very expensive surgery, he continued to dislocate his shoulder. Now we are faced with another surgery. How do we know this next surgery will be any better?
Answer:You should really talk with the surgeon about your questions and concerns. There may be reasons why the first surgery failed that can be avoided the second time. For example, it's very important that the patient follow the surgeon's instructions after the procedure.
Immobilization in a sling is usually advised for four to six weeks. The patient must keep the arm next to the body at all times except when bathing under the armpit. The sling is removed once or twice a day to keep the elbow from getting stiff. But it's very important to avoid moving the shoulder until the surgeon approves.
Sometimes the type of surgery makes a difference for this problem. Arthroscopic repairs are less invasive but have a higher risk of failure. Using this approach, it can be difficult to place sutures far enough down on the tear. Sometimes there aren't enough sutures used. Combining any of these risk factors together can have poor results.
A recent study from California reported on 30 cases of revised Bankart repairs. All patients were athletes involved in overhead sports. After an arthroscopic repair they all had a traumatic event causing the shoulder to dislocate again. A second operation was needed.
This time they had an open revision surgery. The results were good for most of the patients. Many were able to return to their previous level of sports activity. Follow-up over the next four years showed continued good results. All patients in the study rated their satisfaction as good or excellent.Domenick J. Sisto, MD. Revision of Failed Arthroscopic Bankart Repairs. In The American Journal of Sports Medicine. April 2007. Vol. 35. No. 4. Pp. 537-541.
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