This illustration shows the telescope looking into the shoulder joint from the back. At the front of the socket, three anchored sutures (blue) are fixing the torn labrum back to the bone of the glenoid socket. As part of the procedure the stretched inferior capsule of the shoulder is re-tensioned (red arrow). Some intra-operative photographs below show a torn labrum and some of the steps in the repair
Arthroscopic view of an extensive anterior labral tear
Strong suture tape is passed around the torn labrum. A drill hole
is made at the edge of the glenoid socket
The suture is passed through the eye of an anchor which is then driven
into the bone socket to secure the repair
A completed anterior repair with the labrum well restored
An anchor is a surgical implant that secures suture material to bone. The sutures are passed through the tissue to be repaired and then through the eyelet of the anchor. The anchor is then driven into a prepared bone socket to secure the suture inside the bone. No knots are tied inside the joint, so this minimises the chance of any rubbing against the articular cartilage. The anchors used in shoulder surgery are normally made of a 'biocomposite' material. This means they are slowly replaced by bone so that, after a few years, no anchor material remains. The suture material is extremely strong. The flattened design improves compression of the tissue while reducing the chance of the suture cheese-wiring through the repaired tissue. An animation of the anchor system used by Mr Granville-Chapman for instability repair is available here:
You will normally go home a few hours after your operation. You will be in a sling.
Your rehab will involve three phases:
1. Protection (4-6 weeks) - during this time you will need to wear your sling. You will be given some simple exercises but will also need to avoid certain movements to protect your repair.
2. Regain Control and Motion (until 10-12 weeks) - in this phase you will come out of your sling and begin active range of motion exercises. The focus will be on restoring control of your shoulder through range.
3. Strengthening and Functional return (until 5-6 months) - now you will begin to strengthen your shoulder and look towards functional exercises in preparation for your return to normal
Patients vary in their recovery after surgery, but in general you can expect to return to:
Office work after two weeks (in a sling)
Light physical work after twelve weeks
Heavier labour may take 18-24 weeks
Contact sport will take at least six months
Driving will probably take six to eight weeks
By six months, 85-90% of patients trust their shoulder, although further functional recovery is likely out to a year after surgery.
Arthroscopic shoulder surgery is very safe, but specific risks of keyhole shoulder stabilisation surgery include:
Re-dislocation or on-going instability symptoms - most studies report failure rates between 5 and 15% for this surgery at two years – this may include a repeat injury (e.g another rugby tackle). If you continue with contact sports, you may re-injure a successfully stabilised shoulder. The risk is higher in teenagers and those with a history of multiple pre-operative dislocations.
Stiffness (5%) – this rarely requires surgery as the tightened soft-tissues 'stretch out' over time
On-going pain. Occasionally patients notice on-going twinges of pain in their shoulder, despite it being stable and functioning well.
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
A very pleasant Consultant who knows exactly how to make pain go away.
Mr Granville - Chapman has an excellent bedside manner. He engaged with my 12 year old son at an appropriate level and took the time to ensure that he understood the procedure and answer all his questions. He is thoroughly professional and I would not hesitate to recommend him.
I have been very pleased with the attention I have received. Mr. Granville-Chapman has reassured me that my symptoms are normal. It is very easy to make appointments that suit me.
Mr Granville chapman I found be caring informative and professional I would recommend him to all if you have a problem don't hesitate to contact him you won't be disappointed.
I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
So far my experience with Mr Jeremy Granville-Chapman has been personal and informative with regard to the operation I will be having. I feel confident that my operation will be a success and for this reason I am very happy to have Mr Jeremy Granville-Chapman as my consultant.
Very knowledgeable and helpful. Takes the time to make sure you're getting the treatment you need.
Mr Jeremy Granville -Chapman is not only a highly skilled consultant but is able to put you straight away at ease .My appointments were arranged very swiftly which was great, when you are experiencing severe pain. I am very happy with my treatment so far . many thanks to everyone who was involved in my treatment.
Polite, helpful, professional. Makes an effort to ensure full understanding of issues and procedures to be done. Highly satisfied
Very pleasant. Clear, careful explanations & options/possibilities. I feel well informed, and happy that my concerns are being well addressed, with a plan of review of the symptoms.
Excellent advise with everything explained clearly and a successful treatment which has benefited be greatly.
BMI The Princess Margaret Hospital
Osborne Rd, Windsor SL4 3SJ
Spire Thames Valley hospital
Wexham Street, Wexham, Buckinghamshire, SL3 6NH
BMI Bishops Wood Hospital
Rickmansworth Road, Northwood, HA62JW
Wexham Park Hospital, Slough, Berkshire, SL2 4HL