Surgery of Shoulder Instability

Washington University Orthopedics
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Shoulder Instability | Johns Hopkins Medicine

Visible deformity and loss of function of the shoulder occurs after subluxation or sensation changes such as numbness or even partial paralysis can occur below the dislocation because of pressure on nerves and blood vessels. The goal of conservative treatment for shoulder instability is to restore stability, strength, and full range of motion.

How Shoulder Instability Surgery is Performed

Shoulder instability usually occurs when the lining of the shoulder joint, Treatment for shoulder instability includes both non-operative and surgical options. Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects.

Conservative treatment measures may include the following:. When the conservative treatment options fail to relieve shoulder instability, your surgeon may recommend shoulder stabilization surgery.

Shoulder stabilization surgery is done to improve stability and function to the shoulder joint and prevent recurrent dislocations. It can be performed arthroscopically, depending on your situation, with much smaller incisions. Arthroscopy is a surgical procedure in which an arthroscope, a small flexible tube with a light and video camera at the end, is inserted into a joint to evaluate and treat of the condition.

The benefits of arthroscopy compared to the alternative, open shoulder surgery are smaller incisions, minimal soft tissue trauma, less pain leading to faster recovery.

A Patient’s Guide to Shoulder Instability

These individuals may experience multidirectional shoulder instability , which means that the shoulder joint has become unstable without a history of injury or previous significant pain. If your shoulder feels loose or unstable in multiple or all directions, meaning the ball of your shoulder can dislocate from the front, back, or the base of the shoulder.

While the initial dislocation may not cause an extreme amount of pain or trauma, it can lead to continued disc locations, your shoulder joint giving out, and prolonged pain and instability, all of which may require surgery. Another type of shoulder instability is referred to as anterior shoulder instability and can cause anterior shoulder pain or anterior glenohumeral instability, which occurs when the humeral head of the shoulder subluxates or dislocates from the glenoid fossa, causing the function and range of motion of the shoulder joint to be compromised, often leading to recurrent shoulder instability.

Of course, you can always get a shoulder instability test with your orthopaedic surgeon if you think you might be dealing with chronic shoulder instability or a related problem. Severe shoulder injuries or trauma can often be the cause of the initial shoulder dislocation that results in shoulder instability and the potential need for surgery.

Shoulder Arthroscopy

This is because when the head of the main shoulder bone or humerus is dislocated or forcibly moved, the socket bone or the glenoid and the shoulder ligaments are usually damaged as well. In general, shoulder instability happens because of one of two things — some kind of trauma or general laxity or looseness in the shoulder. The two causes of shoulder instability are called traumatic onset versus atraumatic onset, and understanding the differences between the two causes will help you and your doctor determine the best course of treatment.

Shoulder instability surgery is often necessary to repair torn or stretched ligaments that cannot be healed with physiotherapy, since these damaged ligaments cannot hold the hold the shoulder joint in place on their own.

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After all, no amount of rest or physiotherapy can heal a torn shoulder capsule this is the rubbery cap that brings the bones and ligaments of the shoulder joint together. The younger you are when you when you first experience shoulder instability particularly if it is the result of a traumatic injury , the more likely that you will deal with chronic shoulder instability in the future, and the more likely it is that shoulder instability surgery will be recommended.

It is also important to check for co-exisiting injury that might have occurred at the same time as your dislocations. For example, rotator cuff tears, biceps injury or cartilage damage to the shoulder joint. Work with your orthopaedic surgeon to design a treatment around your age and lifestyle. Note that X-Rays or MRIs — or both — will typically be required before your shoulder instability surgery or any other treatment. When you know that you are going for shoulder instability surgery or a similar procedure, you should set yourself and your family and friends who may be available to help out up to succeed in your recovery.

Arthroscopic Stabilization to Treat Shoulder Dislocations

Doing some meal prep and making lots of food that can be frozen and reheated easily is also a good idea, along with setting up some temporary cleaning and laundry services if you can or enlisting some friends or family to handle these tasks. You can begin by thinking about all the times you lift your arms above shoulder height in a given day and try to rearrange the items you regularly use in your home accordingly. More severe cases of shoulder instability can cause extensive bone loss in the ball and socket joint of your shoulder, which means that an open bone graft may need to be performed.

This is called a Latarjet procedure, which is used to treat shoulder dislocations caused by bone loss or a glenoid fracture. In this procedure bone is taken from another part the coracoid which is a projection of bone from the shoulder blade and connected to the front of the socket to offer bony stability of the joint.

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The torn soft tissues are then repaired as well. Your orthopaedic surgeon and their team will work with you to determine the best procedure or course of action for your shoulder instability issues. Stocking up on prepared foods and making meals that you can freeze in advance and enlisting friends and family to help cook for you if you can and scheduling things like cleaning and laundry services are also helpful.

Capsular shift or plication procedure stabilizes the shoulder

You can also move your most commonly used items to lower shelves, drawers, or other easy to reach spots to make life easier before you regain your previous range of motion. Your post-surgery self will thank you! You may also be asked to take non-steroidal anti-inflammatory medication like aspirin or ibuprofen in order to reduce pain and swelling. You may also be required to wear a shoulder instability brace while your shoulder is healing post-surgery on the recommendation of your orthopaedic surgeon.

Physiotherapy may be more valuable for patients who have loose or lax joints or are considered naturally double-jointed, as opposed to those who are not.

Recurrent shoulder dislocation? New U-M procedure effective when standard repairs are not

This is particularly important in younger aged patients as the risk of re-dislocation is higher the younger you are.