Shoulder dislocation is an extremely painful condition where the ball of the upper arm comes out of the shoulder socket. The shoulder socket is shallow and normally, important ligaments help to hold things in place. Unfortunately, if the shoulder dislocates once, often via an injury, it is prone to keep dislocating, because these important ligaments rupture and don’t heal properly. The younger you are, the more likely it seems that recurrence will occur. Some people have loose joints which is a complicating predisposing factor and are often more appropriately treated with physiotherapy or strengthening.
Surgery to repair or reinforce the injured ligaments and prevent recurrent dislocations is called Shoulder Stabilisation
A thorough assessment including a specialised test called an MRI Arthrogram will be required. More than one consultation and repeat examination is normal. During the consultation a discussion covering the advantages and risks of the procedure will take place.
The Surgery and Recovery
There are essentially 2 approaches which are used:
- Arthroscopic anterior stabilisation – This is a minimally invasive procedure in which the ruptured ligaments and their attachment (called the labrum) are reattached to the socket. This is most useful if the shoulder has only dislocated recently, and on only a minimum of occasions.
- Open stabilisation – This is performed via an incision in the crease between the arm and chest, so that it is not too obvious. An open stabilisation will be required particularly if the shoulder has dislocated numerous times in which case, in addition to repairing and tightening the ligaments, extra bone often needs to be grafted to the edge of the socket where it may have worn away.
In each case the procedure is performed under a general anaesthetic. The anaesthetist will also administer a local anaesthetic nerve block, which will alleviate discomfort in the first 48 hours. Usually, the arm will be rested in a sling for 6 weeks to allow initial healing to occur. Further exercises, stretches and strengthening are gradually introduced over the next few months.
The return to recreation and sports is carefully judged, so as not to reinjure the shoulder, particularly while it is healing in the first 6 months.