Shoulder dislocation surgery
Shoulder dislocation surgery is a medical procedure performed to stabilize the shoulder joint after it has been dislocated, particularly in cases of recurrent dislocations or when the initial injury results in significant damage to the joint structures. Below is a detailed explanation covering the anatomy, types of dislocations, indications for surgery, surgical procedures, recovery, risks, and outcomes.
The shoulder is a ball-and-socket joint, where the head of the humerus (upper arm bone) fits into the glenoid (a shallow socket in the scapula/shoulder blade). It’s the most mobile joint in the body, which also makes it more prone to instability.
Key stabilizing structures:
- Labrum – a fibrocartilage rim around the glenoid
- Capsule and ligaments – help hold the humeral head in place
- Rotator cuff muscles – provide dynamic support
Types of Shoulder Stabilization Surgeries
- Arthroscopic Bankart Repair
- Minimally invasive; performed using a camera (arthroscope) through small incisions
- The torn labrum and capsule are reattached to the glenoid rim using suture anchors
- Ideal for patients with soft tissue injury and minimal bone loss
- Latarjet Procedure
- Open surgery (can also be done arthroscopically by experienced surgeons)
- A portion of the coracoid process (a bony projection from the scapula) is transferred to the front of the glenoid
- Provides both bone support and a “sling effect” from the muscle attached to the coracoid
- Preferred for patients with significant bone loss or failed prior stabilization surgery
- Remplissage Procedure
- Performed in conjunction with Bankart repair
- Fills a Hill-Sachs defect (compression fracture of the humeral head) with the infraspinatus tendon
- Prevents engagement of the defect with the glenoid rim
- Capsular Shift or Plication
- Tightens the loose joint capsule
- Often combined with other procedures
Clinical Pathway
- You will be seen by the specialist in outpatient department for clinical evaluation.
- You will be asked certain questions related to your symptoms and examined thoroughly.
- Your investigations such as X-ray, MRI will be reviewed, following which a surgical plan of surgery will be made.
- A detailed explanation will be given to you with regards to surgery along with its pros and cons.
- You will be seen by the anesthetic team
- Your fitness for surgery will be evaluated.
- Investigations including blood tests will be carried out.
- A physical therapist will explain you with regarding to the post op precautions, exercises and immobilization.
- You will be admitted on the day of surgery in the morning. The surgery will be performed under general and regional anesthesia.
- After surgery, you will be under certain medication to control your post operative pain to make you comfortable.
- You will be discharged on the same or next day with post operative instructions.
- Your physical therapy will be started on the next day after surgery and will continue for around three months.
- You will be required to see the specialist in outpatient clinic on couple of occasions to assess the recovery. You were expected to recover completely in approximately three to six months.
If you’re considering or preparing for shoulder dislocation surgery, it’s crucial to:
- Discuss imaging results (MRI, CT) with your surgeon
- Understand the type of injury you have (labrum, bone loss, etc.)
- Commit to rehabilitation, as it’s as important as the surgery itself
Frequently Asked Questions
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Types of Shoulder Dislocation
1. Anterior dislocation (most common, ~95%) o Humeral head moves forward out of the socket o Often occurs with arm in abduction and external rotation 2. Posterior dislocation o Humeral head moves backward o Less common; can occur with seizures or electric shocks 3. Inferior dislocation (luxatio erecta) o Very rare; arm appears locked above the head
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When is Surgery Needed?
Not all dislocations require surgery. Initial dislocations in older patients may be treated conservatively. Surgery is typically recommended in the following cases: • Recurrent dislocations (especially in younger patients) • Significant labral tear (e.g., Bankart lesion) • Bone loss (e.g., Hill-Sachs lesion or glenoid bone loss) • Failure of non-surgical treatment • High-demand athletes or individuals with physically demanding jobs
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Recovery Timeline
Immediate Post-op (Weeks 0–4) • Arm immobilized in a sling • Pain and inflammation managed with medications • Gentle pendulum exercises may begin (surgeon dependent) Early Rehabilitation (Weeks 4–8) • Gradual range of motion (ROM) exercises • Avoid external rotation and abduction early on Intermediate Phase (Weeks 8–12) • Strengthening exercises • Focus on rotator cuff and scapular muscles Advanced Phase (3–6 months) • Return to full ROM and progressive strengthening • Sport-specific or work-specific conditioning Return to Sport/Heavy Activity: 4–6 months, or longer depending on procedure and healing
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Risks and Complications
Although generally safe, shoulder stabilization surgery carries potential risks: • Recurrence of dislocation (lower with surgery vs. non-op) • Stiffness or loss of motion • Infection • Nerve injury (e.g., axillary nerve) • Hardware problems (if anchors are used) • Failure of the repair (especially in high-impact sports) • Arthritis
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Special Considerations
• Athletes: May need additional rehab and clearance before return to contact sports • Older patients: More likely to suffer rotator cuff injuries with dislocation • Young patients (<25 years): High recurrence rate with conservative management; surgery often preferred after the first dislocation
