What is a shoulder dislocation?
The shoulder joint is a ball and socket joint formed by the bumeral head (“ball”) and glenoid (“socket”). A shoulder dislocation occurs when the ball comes out of socket. The shoulder joint is stabilized by ligaments and the labrum; a bumper around the socket. When a dislocation occurs the labrum and ligaments are usually torn off of the socket. This is commonly called a “Bankart Tear”.
What is the treatment for a shoulder dislocation?
The choice of treatment depends on the age and activity of the patient as well the nature of the dislocations.
After a patient’s first dislocation non-operative treatment is usually recommended. Physical therapy is used to strengthen the rotator cuff. These muscles help to stabilize the shoulder by compressing the ball into the socket. Patients are also trained to avoid positions that place the shoulder at risk for dislocation.
Surgery is recommended if a patient continues to have dislocations after completing a course of physical therapy. Also, surgery is recommended after a first dislocation for young patients (less than 18 years old) who participate in contact sports such as football and hockey. Research has shown that these individuals are very likely to have more dislocations if a surgical repair is not performed.
How is surgery performed?
The goal of surgery is to repair the ligaments and the labrum, which have been torn off of the glenoid (“socket”). This operation is completed in a minimally invasive fashion using shoulder arthroscopy. Several small incisions no larger than a centimeter are used.
This is an arthroscopic image taken of one of our patients. This picture was taken before the surgery was performed. The socket is on the bottom left of the screen, the ball of the shoulder above. The labrum can be seen torn off of the glenoid.
This image was taken after the surgery was completed. The labrum is now reattached to the glenoid. A metal probe is seen here testing the strength of the repair.
How long is the recovery after surgery?
You will be wearing a sling for four weeks after surgery. Most patients regain full motion my two months, and are cleared to return to all activity by 4-6 months post op.
Will my shoulder get worse if the surgery is not performed?
Treatment of shoulder dislocations is an elective operation meaning it does not have to be performed. However, if an individual is having repeated dislocations they should give strong consideration to treatment. More shoulder damage can occur with each dislocation. Over time this can damage the ball and socket so that they become more unstable, require larger operations in the future and lead to arthritis.