What is shoulder instability?
Shoulder instability is a problem that occurs when the structures that surround the shoulder joint do not work properly to maintain the ball within its socket. If the joint is too loose, it may slide partially out of place, a condition called subluxation (partial dislocation of the shoulder joint). If the joint comes completely out of place, this is called a shoulder dislocation. During shoulder dislocations, the glenoid and the ligaments in the front of the shoulder are often injured.
How do I know if I need surgery for shoulder instability?
Treatment of shoulder instability depends on several factors and the severity of the patient’s instability. Initial treatment usually begins with conservative management strategies that consist of rest, activity modification, anti-inflammatories, and physical therapy. If your symptoms persist despite conservative treatment, or if you are having recurrent shoulder dislocations, surgery may be needed to restore the shoulder’s stability.
What are the different types of shoulder instability surgery?
Dr. Potts may recommend stabilization surgery if a patient has recurrent instability or extensive damage to the stabilizing structures of the shoulder. Most surgeries for shoulder instability can be performed with minimally invasive shoulder arthroscopy, but if there is significant damage, a more extensive bony procedure may be required. Dr. Potts utilizes the most current surgical techniques in treating anterior shoulder instability, with the goal of restoring the normal anatomy and stability without over-tightening the shoulder. These procedures include:
- Labral repair (Bankart repair) – When a shoulder dislocates anteriorly, the labrum that surrounds the socket may be torn away from the socket (this is known as a Bankart lesion). An arthroscopic procedure is performed to repair a labral tear using suture anchors and heavy suture to reattach the labrum to the socket. The capsular ligaments and labrum is tightened to improve stability and prevent dislocations.
- Capsular shift – Especially following multiple dislocations, the ligaments that hold the shoulder joint in place can become stretched out and lax. A capsular shift tightens the ligaments by creating tissue flaps, then shifting and re-suturing them to eliminate the loose tissue. Capsular shift are usually performed arthroscopically.
- Latarjet procedure – performed when there is bone loss from the socket due to repeated dislocations. The procedure involves placing a bone graft into the worn away portion of the shoulder socket, and securing it with screws. This procedure can be done using an open approach or arthroscopically, depending on the severity of the injury.