You have an initial appointment with your surgeon. In the vast majority of cases, your attending doctor sends a letter containing your medical background or history of the condition with the various treatments implemented. This letter is accompanied by additional examinations, at least X-rays and ultrasound, sometimes arthro-CT or MRI.
The objective of this first consultation is to take stock of your pathology by learning your full history through precise questioning, complete clinical examination of your joint mobility, testing your tendons and muscle, examining laxity, and obtaining clinical scores to objectively quantify your discomfort.
This clinical examination, along with analysis of your additional examinations, will enable your surgeon to offer you specific care: rehabilitation, injections, in-depth examinations, or sometimes surgical indications proposed from the outset (repeated shoulder dislocations, traumatic cuff rupture, complete file with failure of correctly performed medical treatment).
Sometimes a second or even third consultation is needed to analyse the prescribed examinations, seek an improvement following the proposed medical treatments, and review the evolution of your symptoms. Before any surgical decision, a period of reflection is essential, since postoperative recovery lasts several weeks, even several months, and requires rehabilitation and a period of sick leave, which has to be longer for manual activities.
Sometimes there is no other alternative but surgical treatment. This decision is made in consultation between surgeon and patient, in the form of an verbal agreement: you agree to accept the instructions given to you so that your recovery is as quick and simple as possible. It is a team effort where you are at the heart of the care. We do everything we can to ensure that you receive optimal treatment before the surgery, during hospitalisation and after the surgery. Once this decision is made, our assistants will take care of the clinical path: making an appointment with the anaesthesiologist and with one of our physiotherapists for a preoperative training session, and fixing the procedure date according to our timeframes and your preferences.
A surgery is scheduled. This surgery requires anaesthesia, with a minimum delay of 48 hours between the anaesthesia consultation and surgery, except for emergencies.
1/ The aim of this examination is to eliminate a formal contraindication to anaesthesia.
To do this, the anaesthesiologist will conduct a thorough examination of your medical and surgical history, if you have ever been placed under anaesthesia. They will check for allergies and chronic illnesses and analyse your usual drug treatment – anything that could change the usual anaesthesia protocol. This questioning will be complemented by a clinical examination with analysis of your vital signs (breathing, cardiac, etc.). When they deem it necessary, the anaesthesiologist may prescribe an additional assessment, such as a blood test or a chest X-ray. Finally, the anaesthesiologist may also request a specialist consultation in certain cases, e.g. with a cardiologist.
The other objective will be to explain the anaesthesia method to you:
For a large number of surgery, the anaesthesiologist will offer you locoregional anaesthesia coupled with general anaesthesia. This allows a very effective analgesic effect in the postoperative period, because today we know that if the patients have almost no pain when they wake up, they will also have very little in the following days. This type of multimodal anaesthesia has been practised for many years at the Saint Grégoire Private Hospital, and has made it possible to develop outpatient care: cuff repairs, graft-type stabilisation of the shoulder, and a large majority of elbow procedures thus do not require overnight stays in the facility, because pain and anaesthesia-related disorders such as nausea and vomiting are avoided.
Depending on the type of intervention and the schedule, your hospitalization may be either outpatient or conventional.
The follow-up will be done on our premises, by your surgeon and your physiotherapist.