Shoulder Instability
Shoulder Instability
A very common shoulder issue is shoulder instability or dislocation. Shoulder instability refers to inability of the humerus (ball part of the shoulder joint) to stay centered in the socket (glenoid) following a shoulder dislocation event. This should not be confused with a “shoulder separation”, which refers to an injury that causes the collarbone to separate from the shoulder blade. Shoulder instability is a frustrating problem because often patients are unsure about using their arm and never know when their shoulder falls out of socket.
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Non-Operative Treatment Options- Sling: In many cases a dislocation can be treated with a sling for a short period of time, as well as some gradual physical therapy. If you are under the age of 20, there’s a very high likelihood that you may have a recurrent episode of instability. However, many people can be treated without any type of operation and will not have a repeat episode of dislocation.
- Physical Therapy: We often refer patients to physical therapy to rebuild their muscle strength and improve their motion to decrease the likelihood of a repeat dislocation.
- Shoulder Arthroscopy: Shoulder instability can usually be repaired through minimally invasive shoulder arthroscopy surgery. These improved arthroscopic techniques have made early repair a less risky and more effective treatment option. Recurrent dislocations should not be ignored, as these often are the result of or the cause of significant bone loss from the ball and socket, which makes surgical repair more complicated. Recurrent dislocations also caused more cartilage damage in the shoulder joint, increasing the risk of developing arthritis in the shoulder over time.
- Laterjet Procedure: If there is substantial damage to the socket (glenoid) bone or humeral head, bone grafting techniques may be required to restore stability to the shoulder. One technique called a Latarjet procedure actually uses bone from the front of the shoulder to graft the socket. Dr. Hatzidakis learned the Latarjet technique during his training in France. This procedure has been shown to provide excellent stability and overall outcome in patients who have significant socket bone loss, particularly in overhead and collision sport athletes and patients who require revision stabilization procedures.