Surgeons at Burjeel Hospital of Advanced Surgery Dubai have achieved a major milestone by treating a patient for a complicated shoulder injury with complex surgical procedures in just one session - a feat that has only been achieved in a handful of instances across the world. The surgery, which included a bilateral shoulder arthroscopy, acromioplasty, excision of the acromioclavicular joint (AC joint) and rotator cuff repair in both shoulders, usually takes several sessions due to the complexities involved.
Mr. Hassan, who is in his late fifties, consulted with doctors at Burjeel Hospital’s orthopedic department a few months back, complaining of recurrent and severe pain in his shoulders. He was experiencing great difficulty moving his arms and shoulders due to the pain. He was meticulously examined and after using diagnostic tools such as x-rays and an MRI, was diagnosed with arthropathy in both shoulders with impingement syndrome (arthritic inflammation of the joints in the shoulder, as well as the tendons and bursa). This form of inflammation can also lead to the wear and tear of the rotator cuff, which was seen in the case of Mr. Hassan as well. His condition was initially treated with medication, physiotherapy and rehabilitation but he didn’t find much relief and continue to complain of pain. He was also injected with corticoids to relieve the pain but it didn’t help much as he returned to the hospital a few weeks later in severe agony and limited mobility.
Dr. Issam Mardini, Specialist Orthopedic Surgeon, specializing in sports injuries and upper limb treatment at Burjeel Hospital for Advanced Surgery Dubai, led the team treating Mr. Hassan. He said, “Mr. Hassan was in excruciating pain and since the mobility in his shoulders was rapidly declining we advised him on treating his shoulder through surgery. We decided to perform an arthroscopic procedure to excise the damaged AC joints (the joint located at the top of the shoulder) shoulders and repair the rotator cuff tendons of both shoulders. These are complex procedures and done in multiple sessions but we decided it would be advisable to address the problem in a single session due to Mr. Hassan’s other health complications.
“He has cardiovascular issues and was managed earlier by a cardiologist for a stent application for the coronary arteries and had to take blood-thinning medication as a result. He is also diabetic and hypertensive which made the surgery a big challenge and risk for him. Our team of consultants consisting of an orthopedist, cardiologist, internist and anesthesiologist discussed his status and chose the best solution that offered the least risks. We discussed this extensively with the patient and he chose to get both shoulders treated by surgery. He was made aware that both his shoulders would be immobilized for three to four weeks as part of the healing process,” said Dr. Mardini.
Dr. Mardini added, “We took all the necessary steps in line with international standards and the patient’s health condition. Our biggest challenge was to stop the blood thinning medication and accommodate Mr. Hassan’s diabetic status before and during the surgery. We were well prepared for the surgery right from the anesthesia administered to the process involving the repair of the joints and rotator cuffs. Scalene anesthesia was administered to both shoulders, which is a rare and complicated procedure but the anesthesiologist successfully managed the process well. The surgery was performed and went as planned successfully. Another notable point was that the surgery, which usually takes around two hours per shoulder took around two and a half hours in total. This was possible only due to the skill and experience of the excellent team that attended to the patient. Both shoulders were operated using a minimally advanced arthroscopic (keyhole) technique to help Mr. Hassan have a very smooth and safe post-operative recovery.
“He was discharged 48 hours later. He also resumed his routine medication and is expected to start rehabilitation after three weeks to regain function of both shoulders and upper limbs. We are very happy to see Mr. Hassan’s progress and his steady return to a normal pace of life. We performed a challenging surgery that is rarely done even in the world’s top hospitals but the amazing team at Burjeel Hospital Dubai was able to achieve that with great success. I am very proud of this milestone and am excited that we can offer it to patients who really need it in this region.”
Mr. Hassan was also grateful for the efforts of the doctors at Burjeel Hospital. “Dr. Mardini is an excellent surgeon and I believe that the surgery performed is a rare one. I cannot express my gratitude enough for him and his team for their work. I was in such pain and it was unbearable but the team made me comfortable and diligently sought every technique to deal with my problems considering my other health conditions. I am grateful and look forward to completing my rehabilitation and getting back to my usual routine.”