I'm now 6 weeks post op from open latarjet stabilization and arthroscopy. Since surgery I've had numbness on the outside of my shoulder/deltoid. Today, we started doing some active ROM and am unable to lift my arm at all, even tho passively and active-assisted I have the ROM to do it. It's not painful to try to lift it, just extremely weak. After 5 previous surgeries, I pretty much know what to expect in terms of weakness after being in a sling for 6 weeks, and this isn't just weakness, there is no activation at all. I also have considerable muscle wasting of the deltoid and teres minor.

I'm pretty discouraged at this point, I don't see my OS until the 16th for follow up xrays to check bone healing and I'm going to get my PT to talk to the OS. Anyone else have axillary nerve damage after surgery?

Leanne

Leanne,
It would seem to my uneducated but experienced viewpoint that 5+ surgeries results in a LOT of trauma to tissues and every time it is done, the recovery probably takes longer and longer. I have had this discussion with my surgeon. Repeats and revisions come with diminishing returns. 6 weeks is not all that long, as we know. When I spoke with him on 12/23 (he was kind enough to not even charge me or my ins. co) he said he could not in good conscience subject me to any more surgery. Of course, that isn't stopping me from trying to see one last person for a last ditch effort to get out of this nightmare! Hang in there- it may take a LOT longer that anyone would expect due to the repeated trauma.

Hi Leanne,

Sorry to hear of your outcome. I have not read the surgical technic of a Latarjet approach but if it is similar to conventional arthroscopy, there are multiple ways to damage the axillary nerve. Mine permanently was and I was not amused.....also had plexus damage affecting the suprascapular and radial nerves and CRPS. I think these injuries go undereported, personally.

You are at a time frame where you cold undergo EMG/NCV/SSEP to explore the extent of your issues. At 6 weeks, you are not now likely suffering from a simple neuropraxia with your continuation of symptoms, rather now you are looking at a axonotemesis or neurontemesis. Time is on your side and there are repairative procedures that can be done for established nerve damage but needs to be done ideally within 6 months of the surgery. Keep us posted.

Can't nerves heal over a long time, cavitator? I would think that they would be hard to miss in a complex procedure, such as what Leanne had.

Thanks Cavitator,

With latarjet, it's open surgery through deltopectoral interval, coracoid is osteotomized with biceps/coracobrachialis still attached, subscap is split followed by the capsule and the coracoid is attached to the anteroinferior glenoid with two 2 inch screws, followed by capsular shift/bankart. So, they were working very close to the axillary and musculocutaneous. I have biceps function, it's weak, but I can tell it's weakness from disuse. Deltoid weakness is just too advanced to be from disuse being in a sling...I can get 0 active movement. I can abduct my arm but only to about 15 degrees...in other words, that's all supraspinatus. trying to abduct from 15 degrees, there is nothing and any little bit of flexion I have is pec.

I've read such conflicting reports of when EMG should be done, etc. So thank you for the advice. I see my OS in about a week. Luckily, I'm following up with my original surgeon regularly as opposed to the one who did the actual surgery, so I feel this works in my favour as he doesn't have to feel the need to 'cover any tracks' as to what was done in surgery because he has no responsibility to the procedure. I don't see the operating surgeon until mid feb.

At which point would you start to see improvements from a neuropraxia? I even hooked myself up to muscle stim 6 times today with 0 benefit to getting that muscle activated.

Thanks for the help

Leanne

You are good for neurodiagnostics now. Minimum 3 weeks. You are there already. As far as neuropraxia is concerned, by most definitions you should resolved at 6 weeks. You are no better and perhaps worse off by virtue of progressive weakness and atrophy at 6 weeks so I think that labeling and thought has been blown out the back side by now, unfortunately. I suppose it could still be a severe neuropraxia but those are almost always stretch injuries from surgical traction and your approach being open introduces more the thought of direct nerve insult. I don't know but it is certainly fair game to corner the ortho on that, I would think. No harm in persuing the EMS!