Shoulder Instability Surgery

Shoulder Instability Surgery

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Shoulder instability surgery may be recommended if you:

  • Have recurrent shoulder dislocation
  • Have had a shoulder dislocation and are at risk for it repeating -- for example, if you participate in a sport that increases your risk

If nonsurgical treatments and physical therapy haven’t helped, surgery may be your next option to reduce your risk of recurrent dislocations and return you to your daily activities.
 

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How Shoulder Instability Surgery is Performed

Your age, activity level, and the extent of your injury will help your shoulder surgeon determine what type of surgery is best for you. Most procedures are performed using an arthroscope, a tiny camera that is inserted through small incisions into the shoulder joint. Shoulder arthroscopy is a minimally invasive procedure that results in minimal pain. Open stabilization surgery, which requires larger incisions, may be necessary if you have a complex shoulder problem or are at high risk for recurrent instability.

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Types of Shoulder Instability Surgery

Bankart Repair
Also known as arthroscopic labral repair, this common procedure repairs tears to the labrum -- the ring of cartilage around the edge of your shoulder socket. It restores stability to shoulders that don’t have extensive damage from repeated dislocations. If there is extensive injury to the labrum or the bone of the socket joint or you are high risk for recurrence, your doctor may recommend an open Bankart repair.

Remplissage Technique
Sometimes, a dislocated shoulder can result in a dent in the ball part of the joint -- which can cause the shoulder to dislocate again. This arthroscopic procedure fills in the dent in the back of the ball part of the joint by advancing part of the attachment of the rotator cuff into that area, reducing your risk of future dislocations. This may be combined with a Bankart repair.

Latarjet Technique for Shoulder Instability
The bone at the front of the shoulder socket can become chipped or worn away from repeated dislocations. Your shoulder surgeon may use this technique to transfer a piece of bone (the coracoid) and muscles from another part of your shoulder and attach them to the damaged area. Together they keep the ball at the top of your upper-arm bone from slipping out of your shoulder socket.

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Common Questions About Shoulder Instability Surgery

Is the Surgery an Outpatient Procedure?
Yes, the surgery is typically performed on an outpatient basis, and you can go home the same day.

How Long Does the Surgery Take?
The procedure can take 1-2 hours, depending on how complex it is.

Is Shoulder Instability Surgery Painful?
You shouldn’t feel any pain during the procedure. Before the surgery, the anesthesia doctor will use ultrasound to inject numbing medication around your nerves to provide a regional nerve block. The medication numbs the area from your neck down through your arm. The doctor may also give you a sedative to help you sleep through the procedure.

How Long Does Pain Last After Surgery?
The regional nerve block can be short- or long-acting and lasts 18 to 72 hours. You won’t feel much pain the first couple of days after surgery. Your doctor will also recommend you start taking over-the-counter medications, which will keep your pain to a minimum as the nerve block wears off.

What Is the Recovery Time for Shoulder Instability Surgery?
How much time your recovery and rehab take will depend on several factors, including the severity of your injury, how long you had or how often you have had shoulder instability before surgery, and how well you stick with physical therapy appointments and exercises.

How Soon Will I Start Physical Therapy?
You’ll likely start physical therapy within a week after shoulder instability surgery. Over the next 16 weeks or so, you’ll gradually progress from assisted movement (your physical therapist or your good arm moving your affected shoulder) to light resistance exercises, to strengthening exercises. During the first 4-6 weeks, limits on range of motion may be used to protect your repair.

How Soon After Shoulder Instability Surgery Can I Drive?
You can usually start to drive at 6 weeks.

What Other Activity Limits Will I Have?
You should limit heavy lifting until 12 weeks. You should not play contact sports or do Olympic-style weightlifting until 16 weeks after surgery. 

How Soon Can I Return to Sports?
If you’re an athlete, our sports physical therapists can tailor exercises to help you return to your sport safely, maximize your performance, and reduce your risk of re-injury.

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Reviewed: 06/17/2019