Shoulder Instability Repair
Shoulder instability is a condition defined by dislocations or subluxations of the shoulder joint. A dislocation occurs when the end of the humerus (the ball portion) partially or completely dislocates from the glenoid (the socket portion) of the shoulder. A partial dislocation is referred to as a subluxation whereas a complete separation is referred to as a dislocation. The repeated dislocation of the humerus out of its socket is called chronic or recurrent shoulder instability. A tear in the labrum and capsule of the shoulder (a Bankart lesion) may lead to repeated shoulder dislocations. More severe cases may involve damage to the bony structures of the shoulder, which may predispose the patient to a heigher risk of repeat instability.
When these conservative treatment options such as medications, rest, ice application, and physical therapy for strengthening of the shoulder stabilizers fail to relieve shoulder instability, your surgeon may recommend shoulder stabilization surgery. Shoulder stabilization surgery is done to improve stability and function to the shoulder joint and prevent recurrent dislocations. It can be performed arthroscopically, depending on your condition, with much smaller incisions. Arthroscopic stabilization is a surgical procedure to treat chronic instability of the shoulder joint.
Arthroscopy is a minimally invasive surgery and is performed through small incisions (portals), approximately one centimeter length made around the joint area. Through one of the incisions, an arthroscope (small fiber-optic viewing instrument) is passed. A television camera attached to the arthroscope displays the images of the inside of the joint on the television monitor, which allows your surgeon to look at the cartilage, ligaments and the rotator cuff while performing the procedure. A sterile saline solution is pumped into the joint which expands it and gives a clearer view to the surgeon. Injured tissue can be carefully identified.
Your surgeon makes use of small surgical instruments which are passed through the other incisions to treat the condition. The labrum and capsule of the shoulder can be re-attached to the glenoid (socket) using small suture anchors.
Following the procedure, your surgeon will prescribe a period of immobilization in a sling, followed by physical therapy to prevent stiffness and improve range of motion and strength of the shoulder joint. Pain medications will be prescribed to keep you comfortable. The shoulder sling is typically worn for 4-6 weeks to immobilize and facilitate healing, depending on the procedure. Post-operative rehabilitation program including strengthening exercises will be advised for 6-9 months.
The major benefits of arthroscopic stabilization as compared to open repair of instability are that it gives a chance to identify and treat coexisting diseases, decreases pain, complications, and scar tissue formation, combined with shorter hospital stay since the procedure is performed as an outpatient surgery..
As with any surgical procedure, there may be certain risks and complications involved and include infection of the surgical wound, post-operative stiffness, risk of arthritis, muscle weakness and injury to the nerves and blood vessels.