Keyhole surgery offers an optimum solution for 16-year-old sportsman’s dislocating shoulder

16-year-old Jamie’s shoulder was working loose and dislocating. This keen sportsman needed a permanent solution so he could continue to excel at sport.

Aged 13, Jamie broke his collarbone which healed without surgical intervention. At 15, his shoulder started to work loose when playing rugby. When his shoulder eventually dislocated, it was put back in hospital and Jamie started physiotherapy. When the dislocation later recurred, Jamie noticed that his shoulder was getting noticeably looser. Jamie’s father sought medical advice from two shoulder surgeons he knew. Although neither operated on children, a recommendation led him to Mr Ali Noorani. He researched Mr Noorani online, liked what he saw and made an appointment.

Initially, Mr Noorani recommended physiotherapy before any form of surgery, but when this proved ineffective, he explained that there were two ways of surgically intervening; these were:

  • Keyhole surgery to see if there could be some repairs to the torn ligaments as well as cleaning up any debris; and
  • Latarjet, described by Mr Noorani as the “French Method” to use a bone to augment repair.

Mr Noorani warned that in relation to the French Method, that given Jamie’s age, he was not particularly keen to go this route initially because of the risk of arthritis and other bone related issues later on in his life.

Mr Noorani did warn that there was a possibility that the damage might be so severe that the French Method or further surgical intervention might be required, in which case, the goalkeeping career might need to be revisited but he could not make any comment until he had actually seen inside the shoulder. They agreed that a shoulder arthroscopy was the preferred route and this was performed in September 2018.

Jamie’s father was pleased how Mr Noorani understood Jamie’s situation: “Mr Noorani absolutely grasped that Jamie is an excellent goalkeeper and that his aim is to return to goalkeeping in due course. He made it very clear to Jamie that the operation was the start of a journey which Jamie and Mr Noorani would take together.”

He explained how he could help Jamie achieve his return to goalkeeping, but Jamie would need to have patience and work very hard on the physiotherapy side but that between them, they would deliver the results that Jamie wanted. “He (Mr Noorani) made it a team effort such that Jamie felt that he was like a premier league footballer who needed to be back on the pitch as soon as was practically possible.”

Following the operation, Jamie took his course of physiotherapy with Nikos Stamos, his main physiotherapist, recommended by Mr Noorani, extremely seriously and having passed the relevant apprehension test, was signed off by Mr Noorani.

Jamie’s father has been hugely impressed by the combination of Mr Noorani and Nikos Stamos. He says that Mr Noorani offered the highest level of surgical expertise; explained both the nature of the operation and the recovery journey and “showed an extraordinary chemistry and understanding between patient and surgeon” and that Nikos Stamos’s “complete understanding of the shoulder meant he was able to push Jamie hard and give him confidence that his shoulder was healing.”

He adds: “I would have no hesitation in recommending Mr Ali Noorani to any parent; indeed, my nephew is now going to see him with a similar problem. The concept of the journey has been critical in giving Jamie confidence that he will achieve his goal but, at the same time, allowing for ‘wobbles’ along the line.”

Mr Noorani concludes: “As a parent I understand how difficult it is for your child to go through surgery. The decision is never taken lightly. Jamie’s shoulder was very unstable and after his prehab we carried out an arthroscopic repair of the torn ligaments (bankart repair). Sometimes the damage is extensive including bone loss from the socket and in these cases a bone procedure like latarjet can be necessary. Luckily in Jamie’s case the bone loss was minimal so this was not necessary.”

He continues: “Successful surgery in my view is a small but important part of the whole recovery process. It’s a team effort. Jamie was very engaged in his rehabilitation and I referred him to Nikos who was instrumental in his recovery.”

April 2019