Shoulder Stabilization

Shoulder Stabilization Overview

When a traumatic dislocation of the shoulder occurs, especially in younger patients, some ongoing instability is common. Recurring episodes of instability sensation or even re-dislocation in certain shoulder positions can be problematic. Often stability can be restored through an arthroscopic procedure to repair the damaged tissue. A pencil-sized scope and small instruments are inserted through tiny incisions to reattach the torn ligament tissue to the bone. A sling is used for several weeks following, and physiotherapy and shoulder strengthening exercises are prescribed for the first few months. Patients can usually return to sports and full activities in three to four months.

Shoulder Stabilization Details

Dislocation of the shoulder can lead to recurring dislocations or problematic instability. This can cause significant disability in everyday activities, work, or sports. The pathology causing shoulder instability is varied, and may include disruption of the cartilage and ligaments of the shoulder, as well as bone defects which can further compromise shoulder stability. An MRI, sometimes with additional injection of dye, is used to confirm the diagnosis and help to plan appropriate treatment.

When non-operative treatment including physiotherapy fails, surgery can often help to stabilize the shoulder. This is done as an outpatient arthroscopic technique under general anaesthetic. Sometimes an additional nerve block is used for post operative pain relief. Pencil-sized instruments are placed into the shoulder through small incisions while viewing on a magnified monitor. Small sutures and anchors are used to reattach the disrupted tissues. Occasionally additional pathology is addressed at the same operation.

Skin stitches are usually not needed. Long-acting freezing is injected, and a prescription for pain medication is given. Icing is encouraged to assist in pain and swelling control. A sling is worn for the first several weeks following surgery. Exercises commence immediately, and patients are subsequently referred to physiotherapy.

The success of the operation is highly dependent on compliance with the rehab program. Depending on the specific type of instability and surgery, return to activities of daily living will take about 6 to 8 weeks, return to heavy work or sports will be approximately 3 to 4 months, and contact sports can be resumed at 4 to 6 months.

Any operation has potential risks and results cannot be guaranteed. Aside from the risks of anaesthesia (which are very low), possible complications include persistent symptoms of instability (approximately 1 in 10 cases), temporary stiffness (1 in 20), infection (1 in 200 cases), blood clots (1 in 1000) and very rarely nerve or blood vessel damage. Subsequent reinjury of the shoulder can sometimes lead to recurrent dislocation. Smoking, obesity, diabetes, and other medical conditions can adversely affect outcomes.