The shoulder complex is made up of three bones; the humerus, scapula and clavicle. Together these form a ball and socket joint. Shoulder is the most mobile joint in your body and is therefore dependent on strong muscles, ligaments(including the joint capsule) and a rim of cartilage(called the labrum) to stabilise it during movement.
What is shoulder instability?
The shoulder can dislocate (the ball comes completely out of the socket) or subluxate (the ball comes partially out of the socket). Shoulder instability is the result of damage to the shoulder ligaments that keep the ball connected to the socket.
How does shoulder instability occur?
Shoulder ligaments tear from a single violent injury, such as a football tackle or motor vehicle accident. However, they can also be stretched from repeated strenuous use.
How do I know my shoulder is unstable?
In many cases, the patient knows they have shoulder instability because they need someone to reduce the joint back into place. In other cases, the patient primarily complains of pain in the shoulder, with subtle feelings of slipping. The examination in the office usually confirms the diagnosis of shoulder instability.
X-rays are usually ordered to make sure there are no fractures (broken bone) in the shoulder. Commonly, a small fracture in the area of the dislocation can occur on the humeral head, called a Hill-Sachs lesion.
Which structures are damaged in case of instability?
The labrum (where the shoulder ligaments attach) is usually torn in cases of shoulder instability. In addition, there are sometimes fractures of the ball or socket of the shoulder. Rarely, there is also a rotator cuff tear in cases of instability.
What are the treatment options for shoulder instability?
The treatment primarily depends on the patient’s age, activity level, and number of dislocations of the shoulder. When a patient dislocates their shoulder for the first time, they can commonly be treated in a sling with early rehabilitation. However, for patients with repeat episodes of instability, the usual treatment is surgery to fix the ligaments.
How is shoulder instability treated with surgery?
Shoulder instability is usually repaired with arthroscopic techniques. The arthroscope is a fiber optic instrument that is placed into the joint through small incisions. The arthroscope allows me to fully evaluate the entire shoulder joint, including the ligaments, the rotator cuff, and the cartilage surface. Small instruments ranging from 4-5 millimeters in size are inserted through additional incisions so that any injury can be diagnosed and damaged tissue can be repaired, reconstructed, or removed.
What kind of anesthesia is used?
A combination of general anesthesia and regional anesthesia is used for most surgeries.
When can I go home?
1. When your pain is controlled.
How should I care for my shoulder after surgery?
Prior to your discharge, you will be given specific instructions on how to care for your shoulder.
When can I do my normal activities?
This depends upon your symptoms. You can return to work within 3 – 5 days without using the affected arm.
When can I return to sports?
You must have good motion, strength, and control of your shoulder and arm. How quickly you return to sports depends on several factors, including: