Shoulder Surgery

Recurrent Shoulder Dislocation
a) Arthroscopic Bankart Repair
b) Latarjet
Shoulder dislocation
When a shoulder dislocates it can come out of joint either forwards, backwards or downwards
Dislocated Shoulder
When the first dislocation or subluxation occurs the ligaments and labrum are often damaged in the shoulder. This may lead to persistent symptoms of instability.
About your shoulder stabilisation operation
The operation aims to tighten and/or repair the over-stretched and damaged ligaments, rim of cartilage and shape of socket. Different types of operation can achieve this. Your surgical options will be discussed in clinic with your Orthopaedic team and your postoperative rehabilitation will depend on the specific operation.

Rotator Cuff Repair
This leaflet aims to help you understand and gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the WWL NHS Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet.
What is the Rotator Cuff?
The shoulder is a ball and socket joint. The rotator cuff is a group of muscles closely wrapped around the shoulder. These muscles help keep the ball centred in the socket and help to control shoulder movements. These muscles attach on the shoulder blade and onto the top of the arm bone.
The muscles can be torn through general wear and tear or after an accident/fall. The damage usually occurs in the tendon, the area where the muscle joins the bone of the ball. If one or more of these muscle tendons are torn, movement is no longer smoothly controlled and the shoulder becomes weak and painful.

Reverse Shoulder Replacement
This leaflet aims to help you understand and gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the WWL NHS Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet.
The shoulder
The shoulder joint is a ball and socket joint. Most shoulder movement occurs where the ball at the top of your arm bone (the humerus) fits into the socket (the glenoid), which is part of the shoulder blade (the scapula).

Chronic Shoulder Pain
Subacromial decompression surgery
This leaflet aims to help you understand and gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the WWL NHS Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet.
The shoulder
The shoulder is a ball and socket joint with a ligament above it. This forms an arch, which is called the subacromial space. The ligament attaches to bony prominences (the ‘acromion’ and coracoid’) on your shoulder blade.
The ball is controlled and centred in the socket by a group of deep tendons called the rotator cuff. These tendons pass through a small space under the arch. They are protected by a cushion called a bursa. These tendons are involved in all shoulder movements and function.
Subacromial impingement
If the subacromial space narrows, the bursa or tendons can become inflamed and painful. This condition is known as a subacromial impingement.

Arthroscopic ACL reconstruction
Anterior Cruciate Ligament (ACL) Reconstruction Surgery
This leaflet aims to help you gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the Wrightington, Wigan and Leigh NHS Foundation Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet. This guide has been prepared to help you recover from surgery and to answer many frequently asked questions. It is designed to complement the advice of your surgeon and physiotherapist.
What is the Anterior Cruciate Ligament?
The anterior cruciate ligament (ACL) is one of the main stabilising ligaments in the knee. It prevents the tibia (shin bone) from sliding forward on the femur (thigh bone). It also resists rotation of the femur on the tibia, especially when the knee is slightly bent e.g. during twisting and cutting manoeuvres. It helps to resist sideways movements of the knee joint e.g. when being “tackled” from the side; and the ligament provides significant feedback information to the muscles surrounding the knee, allowing co-ordinated activities.
ACL tears most commonly occur in people who participate in sports, i.e. rugby, football, netball and skiing and commonly occur as an indirect (non-contact) incident for example landing from a jump, pivoting, or suddenly decelerating. Tears can also be as a result of direct trauma (contact).

Patellar Dislocation – MPFL reconstruction
What is the Medial Patellofemoral Ligament?
The medial patellofemoral ligament (MPFL) helps to stabilise the patella (knee cap). The ligament attaches to the upper third of the patella and the inner aspect of the femur (thigh bone). It functions as a tether to stop sideways movement and dislocation of the patella.
MPFL tears happen when the patella is dislocated either traumatically e.g. following a tackle during sport, or atraumatically due to instability because of ligament laxity or reduced thigh muscle strength and control.
Some people can function satisfactorily without an MPFL by working on a programme of intensive rehabilitation. If symptoms of patella instability persist, a reconstruction of the ruptured ligament is often necessary.
You and your surgeon have decided that an MPFL reconstruction is the best way to manage your injury. The expected outcome of surgery is:
- Improved knee stability
- Improved function/mobility
- Reduced pain
- Recovery of function and return to previous level of sport.

Arthroscopic Meniscus Surgery
The Meniscus
The meniscus is a “C” shaped, wedge like structure made of cartilage which sits between your tibia (shinbone) and your femur (thigh bone). It acts as a cushion to absorb shock and protect the surfaces of your knee joint. Your knee contains a meniscus on the inner (medial) side and one on the outer (lateral) side.
A torn meniscus is a common knee injury. Activities which cause you to forcefully twist or rotate your knee, especially when putting the pressure of your full weight on it can lead to a tear.
Some meniscus tears can heal without surgical intervention.
Unfortunately, the meniscus does not have a good blood supply and some tears do not heal. The torn meniscus may catch within the knee joint causing locking of the knee and loss of range of movement

HTO
Osteoarthritis of the knee
When osteoarthritis occurs in the knee, the articular cartilage becomes rough and thin and can wear down to expose the underlying bone. Articular cartilage is a layer of firm, slippery material that covers the ends of bones which make up joints. In the knee joint there is articular cartilage on the end of the femur (thigh bone), the top of the tibia (shin bone) and the back of the patella (knee cap). The bone at the edge of your joint can grow outwards forming bony spurs called osteophytes. The knee may swell and becomes gradually more painful over time.
If the knee joint is mal-aligned then abnormal forces cause excessive pressure on either the medial (inner) or the lateral (outer) aspect of the knee. Osteoarthritis in a mal-aligned knee can mean that while one side of the knee joint is damaged, the other side is relatively well preserved.
In your case, the medial aspect of your knee is damaged by osteoarthritis. You may be aware that your leg has become more bowed and this may impair your walking ability and cause pain even when at rest.

Recurrent Shoulder Dislocation
a) Arthroscopic Bankart Repair
b) Latarjet
Shoulder dislocation
When a shoulder dislocates it can come out of joint either forwards, backwards or downwards
Dislocated Shoulder
When the first dislocation or subluxation occurs the ligaments and labrum are often damaged in the shoulder. This may lead to persistent symptoms of instability.
About your shoulder stabilisation operation
The operation aims to tighten and/or repair the over-stretched and damaged ligaments, rim of cartilage and shape of socket. Different types of operation can achieve this. Your surgical options will be discussed in clinic with your Orthopaedic team and your postoperative rehabilitation will depend on the specific operation.

Rotator Cuff Repair
This leaflet aims to help you understand and gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the WWL NHS Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet.
What is the Rotator Cuff?
The shoulder is a ball and socket joint. The rotator cuff is a group of muscles closely wrapped around the shoulder. These muscles help keep the ball centred in the socket and help to control shoulder movements. These muscles attach on the shoulder blade and onto the top of the arm bone.
The muscles can be torn through general wear and tear or after an accident/fall. The damage usually occurs in the tendon, the area where the muscle joins the bone of the ball. If one or more of these muscle tendons are torn, movement is no longer smoothly controlled and the shoulder becomes weak and painful.

Reverse Shoulder Replacement
This leaflet aims to help you understand and gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the WWL NHS Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet.
The shoulder
The shoulder joint is a ball and socket joint. Most shoulder movement occurs where the ball at the top of your arm bone (the humerus) fits into the socket (the glenoid), which is part of the shoulder blade (the scapula).

Chronic Shoulder Pain
Subacromial decompression surgery
This leaflet aims to help you understand and gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the WWL NHS Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet.
The shoulder
The shoulder is a ball and socket joint with a ligament above it. This forms an arch, which is called the subacromial space. The ligament attaches to bony prominences (the ‘acromion’ and coracoid’) on your shoulder blade.
The ball is controlled and centred in the socket by a group of deep tendons called the rotator cuff. These tendons pass through a small space under the arch. They are protected by a cushion called a bursa. These tendons are involved in all shoulder movements and function.
Subacromial impingement
If the subacromial space narrows, the bursa or tendons can become inflamed and painful. This condition is known as a subacromial impingement.

Arthroscopic ACL reconstruction
Anterior Cruciate Ligament (ACL) Reconstruction Surgery
This leaflet aims to help you gain the maximum benefit from your operation. It is not a substitute for professional medical care and should be used in association with treatment at the Wrightington, Wigan and Leigh NHS Foundation Trust. Each person’s operation is individual and you may be given specific instructions that are not contained in this leaflet. This guide has been prepared to help you recover from surgery and to answer many frequently asked questions. It is designed to complement the advice of your surgeon and physiotherapist.
What is the Anterior Cruciate Ligament?
The anterior cruciate ligament (ACL) is one of the main stabilising ligaments in the knee. It prevents the tibia (shin bone) from sliding forward on the femur (thigh bone). It also resists rotation of the femur on the tibia, especially when the knee is slightly bent e.g. during twisting and cutting manoeuvres. It helps to resist sideways movements of the knee joint e.g. when being “tackled” from the side; and the ligament provides significant feedback information to the muscles surrounding the knee, allowing co-ordinated activities.
ACL tears most commonly occur in people who participate in sports, i.e. rugby, football, netball and skiing and commonly occur as an indirect (non-contact) incident for example landing from a jump, pivoting, or suddenly decelerating. Tears can also be as a result of direct trauma (contact).

Patellar Dislocation – MPFL reconstruction
What is the Medial Patellofemoral Ligament?
The medial patellofemoral ligament (MPFL) helps to stabilise the patella (knee cap). The ligament attaches to the upper third of the patella and the inner aspect of the femur (thigh bone). It functions as a tether to stop sideways movement and dislocation of the patella.
MPFL tears happen when the patella is dislocated either traumatically e.g. following a tackle during sport, or atraumatically due to instability because of ligament laxity or reduced thigh muscle strength and control.
Some people can function satisfactorily without an MPFL by working on a programme of intensive rehabilitation. If symptoms of patella instability persist, a reconstruction of the ruptured ligament is often necessary.
You and your surgeon have decided that an MPFL reconstruction is the best way to manage your injury. The expected outcome of surgery is:
- Improved knee stability
- Improved function/mobility
- Reduced pain
- Recovery of function and return to previous level of sport.

Arthroscopic Meniscus Surgery
The Meniscus
The meniscus is a “C” shaped, wedge like structure made of cartilage which sits between your tibia (shinbone) and your femur (thigh bone). It acts as a cushion to absorb shock and protect the surfaces of your knee joint. Your knee contains a meniscus on the inner (medial) side and one on the outer (lateral) side.
A torn meniscus is a common knee injury. Activities which cause you to forcefully twist or rotate your knee, especially when putting the pressure of your full weight on it can lead to a tear.
Some meniscus tears can heal without surgical intervention.
Unfortunately, the meniscus does not have a good blood supply and some tears do not heal. The torn meniscus may catch within the knee joint causing locking of the knee and loss of range of movement

HTO
Osteoarthritis of the knee
When osteoarthritis occurs in the knee, the articular cartilage becomes rough and thin and can wear down to expose the underlying bone. Articular cartilage is a layer of firm, slippery material that covers the ends of bones which make up joints. In the knee joint there is articular cartilage on the end of the femur (thigh bone), the top of the tibia (shin bone) and the back of the patella (knee cap). The bone at the edge of your joint can grow outwards forming bony spurs called osteophytes. The knee may swell and becomes gradually more painful over time.
If the knee joint is mal-aligned then abnormal forces cause excessive pressure on either the medial (inner) or the lateral (outer) aspect of the knee. Osteoarthritis in a mal-aligned knee can mean that while one side of the knee joint is damaged, the other side is relatively well preserved.
In your case, the medial aspect of your knee is damaged by osteoarthritis. You may be aware that your leg has become more bowed and this may impair your walking ability and cause pain even when at rest.