Shoulder surgery in Enfield

The shoulder is a complex structure. It has three bones, which are connected with tendons, ligaments, muscles, and other soft tissues. These bones are the shoulder blade (also called the scapula), the collar bone ( the clavicle), and the upper arm bone (called the humerus).

The shoulder may appear to be one joint, but it is actually made up of three joints (or four, if we count the one between the end of the shoulder blade and the rib cage). These joints are:

• The sternoclavicular joint, which sits between the top of your chest bone (or sternum) and the collar bone (or clavicle)
• The acromioclavicular joint, which is between the collarbone and the acromion — the highest point of your shoulder blade
• The glenohumeral joint, which sits between the top of the upper arm bone and the shoulder blade. This is the larger, main joint that people think of as the shoulder joint It is a ball-and-socket joint: the round top of the upper arm bone is the ‘ball’, and the socket is called the glenoid and is part of the shoulder blade
• The scapulothoracic articulation is sometimes counted as one of the shoulder joints. The shoulder blade glides against the rib cage at this point, but no ligaments hold the bones together

The top of the bones in the shoulder that glide against each other are covered with protective cartilage. This acts as a shock absorber and enables the bones to glide smoothly and not rub against each other.

Other important soft tissue components in the shoulder joint include:

• The labrum: this piece of cartilage covers the glenoid
• The bursa: this is a small sac around the large glenohumeral joint. It is filled with synovial fluid, which lubricates the joints
• The rotator cuff describes a group of tendons and muscles that run from the shoulder blade to the top of the upper arm bone. They stabilise the joint and help you lift your arm
• The shoulder capsule. This is the strong connective tissue that holds together the large ball-and-socket joint (glenohumeral joint)

There are several conditions that may cause pain and reduced function of your shoulder. These conditions may result from trauma, such as sports-related injuries, or degenerative conditions, such as arthritis.

Many of these conditions can resolve on their own, or with non-surgical treatment options, such as:

• Rest
• Painkillers
• Physiotherapy
• Steroid injections

However, sometimes these therapies aren’t effective enough at managing shoulder pain or the underlying condition.

If non-surgical treatment options do not relieve the symptoms, further investigations and surgery may be required.

Before recommending surgery, your consultant will follow these procedures to help diagnose what is causing you shoulder pain:

• They will ask you questions to establish your medical history
• They will perform a thorough physical examination of your shoulder
• They will enquire how long the pain has lasted/not responded to other treatments
• They may request imaging tests, such as X-rays and MRIs (magnetic resonance imaging)

An accurate diagnosis is essential to ensure you receive the most appropriate treatment — whether surgery or otherwise — for your specific condition.

There are several types of shoulder procedures, and they depend on the conditions they are aiming to treat.

From the perspective of the technique that is being used, shoulder surgery can be broadly divided into arthroscopic surgery and open surgery.

Arthroscopic shoulder surgery, also called shoulder arthroscopy or keyhole shoulder surgery, is a less invasive procedure than traditional open surgery. It has become increasingly popular in recent years, following the high success of the arthroscopic technique for treating other joints, such as the knee or hip.

During arthroscopy, you may receive general, local, or spinal anaesthesia. The surgeon will create a small incision in the skin above your joint and insert a small tool called an arthroscope. This is a long, thin tube with a fibre optics system, a camera, and a light at the end.

The information is transmitted to a screen, which enables the surgeon to make an assessment and/or treat the joint. Arthroscopy can be used both as a way of diagnosing shoulder problems and treating them.

During the procedure, your surgeon will often make an additional small incision to add other small surgical tools that will help treat and repair the shoulder.

Open surgery involves incisions of several centimetres long, which are larger than the arthroscopic ones.

Some of the situations that may require open shoulder surgery include:

• Rotator cuff repair, if there is a need for a more complex procedure such as reconstructing the tendon.
• Labral repair, if the injury also damaged the bone of the socket.
• Shoulder stabilisation through the Latarjet procedure. This procedure is recommended in the case of repeated shoulder dislocations, which end up causing bone loss from the socket. In this open surgery, a bit of bone from another part of the shoulder is grafted onto the damaged area of the shoulder socket and attached using special screws.
• Shoulder replacement surgery due to severe arthritis.

Shoulder replacement surgery

People with advanced arthritis of the shoulder whose glenohumeral joint is severely damaged may benefit from shoulder replacement surgery. In this procedure, the affected parts of the joint are replaced with artificial parts called implants or prostheses.

There are three different types of shoulder replacement:

• Partial shoulder replacement, or hemiarthroplasty. In this procedure, only the top of the upper arm bone is replaced with a prosthesis.
• Total shoulder replacement or arthroplasty. The top of the upper arm bone is replaced with a metal ball, and the glenoid replaced with a plastic socket. This recreates the ball-and-socket joint.
• Reverse total shoulder replacement or arthroplasty. In this procedure, the positions of the metal ball prosthetic and the plastic socket prosthetic are reversed. The socket goes into the top of the upper arm bone, and the metal ball goes into the glenoid.

Risks of shoulder replacement

Possible complications after shoulder replacement surgery include:

• Anaesthesia risks
• Infection (rare)
• Prosthesis problems
• Excessive bleedingBlood clots
• Nerve damage (very rare)
• Blood vessel damage (very rare)
• Shoulder dislocation (very rare)

Again, your consultant will talk you through any possible risks during your consultation.

What is the success rate of shoulder replacement surgery?

Studies have found that 9 in 10 shoulder replacements typically last for at least a decade. During this time, patients have reported:

• Improved shoulder function
• Less pain
• Improved strength
• Improved ability to perform day-to-day tasks
• Better overall quality of life

Most arthroscopic procedures are done on an outpatient basis, meaning you can go home the same day. However, you may have to wear a sling for a few weeks.

The incisions create wounds that can take several days to several weeks to heal. You may be able to return to your normal activities within weeks or sometimes even days, depending on the complexity of the procedure and your overall health and fitness levels.

More complex surgery procedures may require you to do physical therapy to recover fully. Rehabilitation programs may last anywhere between a few weeks to a few months.

Shoulder replacement surgery requires physical therapy from the first day after surgery. You will start with small movements and exercises. Usually, most people can do simple day-to-day tasks such as eating or getting dressed within two weeks after surgery.

However, you may not be able to lift anything heavy for 2–4 weeks after surgery. You may also not be able to drive for 2–6 weeks after surgery.

Skip the waiting times and get quick access to The Cavell Hospital’s network of leading experts in shoulder conditions.

The hospital boasts well-versed, internationally-trained surgeons who will oversee every aspect of your care — from your first consultation to your treatment and through to a smooth and hopefully swift recovery.

Not only are our consultants dedicated to offering the highest quality care, but so is our whole hospital staff. Our leading radiologists, physiotherapists, and other healthcare professionals are sure to make your patient journey as pleasant as possible — starting with your initial consultation and ending in your post-operative recovery.

The dedication of our team reflects in our patients’ satisfaction. Independent surveys show that 98.6% of the people who have received care at the Cavell Hospital are likely or extremely likely to recommend this facility to friends and family.

Surgery costs at The Cavell Hospital

Cost is a key aspect when you consider private shoulder surgery. At The Cavell Hospital, we offer fixed-price packages that include the first consultation, treatment, and aftercare.

We also offer flexible payment options that make high-quality private healthcare more accessible than you might think.

You can also use your private health insurance to pay for care at The Cavell Hospital.

The Cavell Hospital is just outside of Enfield town centre. It is easily accessible to those living in Enfield, North London, and farther afield by train, bus, or car. The hospital is located at Cavell Drive, Uplands Park Road, Enfield, London, EN2 7PR. For instructions on how to get to us by road, train, or bus, click here.

With consultations available at our private hospital in Enfield six days a week, we can help you access the expert-led care you need without delay.

It is easy to book a private consultation at The Cavell Hospital with a shoulder specialist of your choice. You can either book your appointment online or phone us on 0208 02338284.