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should i get shoulder stabilization surgery?

post #1 of 18
Thread Starter 
i'm schedule to get stabilization surgery next friday the 14th. I dislocated it about 8 months ago on a hard fall off a cornice. it popped back in and I skiied down. Then I skiied the next day (one of the best powder days i've had). I thought I was alright, then a week later it popped out in my sleep. Terrible thing to have happen.
Then, I saw a doc, saw another doc, did some physical therapy, and was recommended surgery.
But...I haven't had any problems since then--no more dislocations, very little or no pain. Its not bothering me.
I guess I don't know what else to add, but I'd have to miss at least half the ski season to get this surgery, I think. Lately, I am thinking I could give this ski season a try without getting surgery. Do more physical therapy and see if it pops out again.
Although the surgeon basically recommended getting the surgery (said its what he would do) and thought it likely I would dislocate it again (and risk injurying it worse or suffering nerve damage), a lot of advice I've been reading online said to first exhaust physical therapy as an option and it doesn't seem like i have. Also the advice all says to get the surgery if you're under 30 and not to if you're over 30. Well I'm 30, so where does that leave me?
So, basically I'm looking for anecdotes or advice from people that have suffered similar injuries.
post #2 of 18
Here was my experience, but it wasn't with a dislocation. I tore my rotator cuff badly at a local resort last February. They set the hill up for a FIS Super G practice. They had run one of the ropes that held up the safety netting down past the finish to one of the lift towers that was in a crossing trail at the bottom of the hill. It was foggy, dark and snowing. I went on the small side of the crossing trail to get around some snowboarders. The rope was unmarked. I skied into it, but managed to get my arm in front of my throat and face. It ripped my arm over head and tore the tendon to my supraspinatus muslce, a classic rotator cuff tear, my doc told me. Anyway, being a flexible, loose jointed 52 year old in pretty good shape from yoga, lifting and stuff, I just thought it was a sprain, but had trouble putting my coat on the next day. It never got better. It got worse. My doc told me that if I didn't fix it, I would start to lose function in my arm within the next decade. So, this summer, I had surgery to fix it. Spent the better part of the last three months doing little with my arm. Shoulder surgery is really painful and the recuperation is long and slow. If you go too fast after having a tear repaired, it has to done over. I know this from people in the supermarket who saw me and related their stories to me. I still can't sleep on that side and my other side is sore every morning from not being able to turn over. But, I didn't have a dislocation. It was a serious tear. How long of a recuperation did they tell you, btw?
post #3 of 18
Thread Starter 
well they can't really say until they look inside of me and see the damage. up to 4 months for full, ready to do most activities recovery is the worst-case. best-case, if its not as bad as they think, could be less.
post #4 of 18
This is ridiculous for a bunch of reasons.

1. What is wrong with your shoulder? Do they know? Have you had an MRI or preferably MR arthrogram? That would tell alot.

2. You trust us to make this decision with you? I know I'm skilled and educated but for all you know I could be a 15 year old kid strung out on crack playing video surgeon on my PSP in between posting on this forum.
post #5 of 18

I've been there...

I had my first anterior dislocation of my left shoulder six years ago, when I double ejected out of my Marker bindings, when I would have rather stayed in them...but that's another story. Anyhow, my docs said the same thing...since I was 26 at the time, try physical therapy and stay away from the surgery. Well...I'm a pretty active guy and through the course of skiing, mountain biking, playing with the kids, etc. it kept dislocating. When it would pop out in my sleep, or when reaching to pay at the fast food drive thru window, I knew it was just too much.

So, last October, after 100+ discloations over five years, on the same day Mammoth got the 5-ft dump, I had my shoulder fileted open and reconstructed. Recovery was hell...it hurt...PT hurt...and I missed a lot of an epic season. My only regret...I waited so long. The ortho said I would have been a lot better off if had gone under the knife sooner, but then again, he only knew that because he opened me up.

So, my advice is hit the PT, get an MRI, and if it keeps dislocating, decide which season you'd rather miss...winter or summer, because when you go under the knife, you'll be out of action for 4-6 months.

Two cents from a guy who has been there...
post #6 of 18
Thread Starter 
thanks. yeah I got an MRI. Frankly MRIs don't seem that useful for this particular injury. I mean they can't tell until they arthroscope.
thanks Jim S.
Yeah I'm not looking for medical answers here, just first hand stories from people in similar situations.
post #7 of 18
Quote:
Originally Posted by alkupe
thanks. yeah I got an MRI. Frankly MRIs don't seem that useful for this particular injury. I mean they can't tell until they arthroscope.
Not true. MRI is great for rotator cuff and OK for instability. MR arthrography is great for shoulder instability. Not good, great.

I do this for a living.
post #8 of 18
Thread Starter 
what is MR arthrography?
post #9 of 18

MR Arthrogram

We inject a mixture of contrasts (fluid) into the glenohumeral (shoulder) joint. MR contrast and the distention of the joint allow us (radiologists) to see the labrum and glenohumeral ligaments much better than in a conventional MRI. We get the contrast into the joint by an IV injection or injecting directly into the joint. I prefer the latter.

If done right, it barely hurts and the images are fantastic. I do about 1-2 a week.

We can do this with any joint but in particular elbows, hips and knees that have had previous meniscal surgery.
post #10 of 18
Thread Starter 
hmm interesting. this wasn't presented to me as an option.
As for the MRI, it did reveal something, but its clear from talking to the surgeon that they don't know how bad it is until they're in there.
post #11 of 18
It depends on the surgeon. Here are two extremes:

I know one who won't touch anybody unless they have an MR arthrogram, even for suspected cuff disease when instability is not an issue.

I know another who orders regular MRIs and then will operate for instability; he rarely orders MR arthrograms for instability cases.
post #12 of 18
Very informative advice your getting here about some of the options. I know nothing about this other than my own experience with my own tear. I've faced medical issues in the past, though, and always got a second and even third opinon. Have you done that?
post #13 of 18
I dislocated my shoulder posteriorly in a skiing accident a couple years ago. I never had surgery and was able to regain full function with PT. Banditman is right, the PT is an excruciatingly long & painful process. I had a MR Arthogram done at one point, and in my case it showed that my shoulder was able to heal on it's own. I havent had any problems with instability or the shoulder popping out, so my situation is different from yours.

My recommendation be to have the MR Arthogram done first to see what's happening inside your shoulder, then get the surgery if it reveals problem
post #14 of 18
Wow, posterior dislocs are exceedingly rare.

Rehab: tangentially, the rehab for my ACL autograft was the most painful thing in my life.
post #15 of 18
Yeah, that's what my doctor & physio both said. They had never seen a posterior dislocation. That's just like me, to do something out of the ordinary
post #16 of 18
Thread Starter 
thanks all for the advice. I've decided to postpone fixing my shoulder until after ski season. One concern is that I would be tempted to rush back too soon and ski. After ski season, I will be able to relax and take the time I need to heal it. Perhaps in the meantime I will get one of these MR Athrograms. And I will ski and try not to hurt myself.
post #17 of 18
Quote:
Originally Posted by Jim S
This is ridiculous for a bunch of reasons.

1. What is wrong with your shoulder? Do they know? Have you had an MRI or preferably MR arthrogram? That would tell alot.

2. You trust us to make this decision with you? I know I'm skilled and educated but for all you know I could be a 15 year old kid strung out on crack playing video surgeon on my PSP in between posting on this forum.
LMAO, they have that game
post #18 of 18
This makes a lot of sense, especially given that you have had deep intuitve reservations about this specific surgery. Good Luck!
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