The dr tried really hard to not have to open him up but in the end had to because the front muscle that goes across the shoulder was tearing away from the bone. The reason why the front muscle was tearing away from the bone was because the tendon that attaches to the bicep (has a nice little groove that it sits in)no longer sits in the groove and therefore, was pushing the front tendon up. All the other "procedures" which included repairing another tendon in the back, removing a bone spur from inside the ball and socket, and building up the cuff were all done at the beginning of the surgery and othroscopically. I will try to explain everything to you with the pictures that we have of the inside of the shoulder. All the "yellow" coloration is iodine. There is tape on top of all the stitches so you can't really see the damage. They did cut right on the old scar -from surgery in the late 80's. For some reason this picture will not turn.
If you have a weak stomach don't look at the following pictures. This is the drill they used to remove the bone spur. These are pictures of the inside of ball and socket. Building up the cuff was difficult because from the 80's surgery they had left some of it in and it had actually healed to the back side of the socket. They pried, chiseled the healed cuff and raised it back up into place. This took about 1 1/2 hr (longest part of the surgery) and was done all orthroscopically. If you have a healthy shoulder, it shouldn't be all shaggy looking like his are. Basically all of these problems are from dislocating his shoulder over and over and wearing away the bone and stretching the tendons. The metal you see in this picture is another instrument. The blue you see is sutures building and securing all the cuff work. the bottom left picture is the cuff not repaired yet.
The 2nd row, 2nd down picture is of the inside of the socket where it is a little "rough" from arthirist. The dr was very pleased and thought that his should would be covered with it but there was only a small amount.The metal you see is again instruments they used in surgery. They put in 4 bio degratable screws. So someday they will no longer be there. He has alot of work that has to be done