Shoulder SurgeryDr Grey is a specialist orthopedic shoulder surgeon based in Cape Town.
Dr Grey is experienced in treating all shoulder injuries and problems such as rotator cuff tears, sub-acromial bursitis, impingement, calcific tendonitis, biceps problems, fractures, unstable shoulders, acromioclavicular joint injuries, frozen shoulder, and shoulder arthritis.
Before surgery is considered:
During the first consultation Dr Grey will take time to find out more about your health and the nature of your shoulder problem. He will examine you to identify the origin of pain, assess the shoulder movement and stability, and he will measure the power in the various muscles attaching to the shoulder. It is advisable to wear a vest underneath your clothes to allow easy access to your shoulder without undressing completely.
Depending on the suspected shoulder condition, he may perform an ultrasound scan in his rooms to assess the rotator cuff, sub-acromial bursa, biceps tendon and acromio-clavicular joint. When a cortisone injection is required he will use ultrasound-guidance to ensure the injection is performed accurately. You may be sent for X-rays as well to assess the shoulder joint and bony architecture, however, this is not always required. In certain scenarios a MRI scan or CT-scan may also be required.
Dr Grey will discuss your diagnosis and management options with you. Many shoulder problems can initially be treated by conservative means which may include medication, cortisone injections and/or physiotherapy. Please have a look at the list of shoulder problems in the Patient Education section. If surgery is indicated, he will explain the proposed procedure, alternative procedures, as well as the risks involved. Please feel free to ask questions during this process.
Open or arthoscopic (“key-hole”) surgery?
Dr Grey is experienced in both arthroscopic and open surgical procedures. Most of the soft tissue operations performed on the shoulder can be performed arthroscopically through small skin incisions. Besides the cosmetic advantage of having smaller scars, this also causes less damage to the overlying deltoid muscle and therefore less deltoid weakness afterwards. There is also a lower infection risk with arthroscopic surgery.
Certain operations such as fracture fixation surgery, Latarjet procedure and shoulder replacements require wider surgical exposure and are therefore performed as open procedures. Care is taken to minimize damage to surrounding structures to reduce bleeding and lower the infection risk. When possible, a dissolvable suture is used with skin suture strips to help form a thin scar.
The morning of surgery
You will be informed about the time of your surgery and admission time. You will need to present yourself to hospital about 2 hours before surgery as the admission process can be quite tedious. There is a pre-admission clinic at Kingsbury Hospital where you can complete most of the paperwork the day before surgery to speed up the admission process. Please be starved (nothing to eat or drink) for at least 6 hours before surgery.
Depending on the surgery performed and the time of surgery, you may be allowed to go home on the same day or the following morning. If pain is expected to be severe after surgery it is advisable to stay overnight to optimize pain management. Other factors influencing the length of stay will be the use of surgical drains and intravenous antibiotics. You will be issued with a sling and instructed about its use. Please have a look at the post-operative rehabilitation information sheets in the “Patient Education” section. Dr Grey will refer you to a physiotherapist when required. The first follow-up visit is normally at 2 weeks after surgery to assess your surgical scar(s).
Please have a look at the post-operative rehabilitation information sheets in the Patient Education section.
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