What is a recurrent shoulder dislocation?
A shoulder dislocation occurs when the shoulder capsule, ligaments, or labrum rupture or detach from the bone. This causes instability in the joint. If additional dislocations occur after the first one, the condition is called recurrent shoulder dislocation.
Shoulder dislocation can be caused by a shoulder injury or trauma. Each time a dislocation occurs, there is a risk that the damage will worsen and that the shoulder will progressively deteriorate over time. Recurrent shoulder dislocation is a precursor to early-stage osteoarthritis.
There are several non-surgical treatment options for people with recurrent shoulder dislocation.
- Physiotherapy is the preferred treatment after the first dislocation.
- Physiotherapy is the treatment of choice for multidirectional dislocations in patients that have greater than normal ligament laxity.
The goal of surgical treatment is to prevent repeated dislocations that cause a deterioration and loss of function of the shoulder. There are three possible scenarios:
- If the ligament is torn or if the labrum is too loose, arthroscopic repair is recommended, which involves repairing or reinserting the capsulolabral complex. Capsular plication is sometimes also necessary (Bankart repair with or without capsular plication).
- If there is a large, avulsed bone fragment, open surgery with a bone transfer may be required (Latarjet procedure).
- If there is significant damage to the postlateral head of the humerus (called a Hill–Sachs lesion), a remplissage procedure is performed in addition to the standard procedure. This involves attaching the rotator cuff tendon to the lesion.
About the procedure
- Outpatient arthroscopic procedure (very small incisions using very small surgical instruments)
- Length of procedure: 45 to 90 minutes
- Regional anesthesia (the entire arm and shoulder are blocked) by an anaesthesiologist. The patient remains conscious during the procedure.
- If the patient would like to be sedated, a mild, short-acting sedative can be administered.
Patients may be escorted home approximately one hour after their procedure. Numbness in the shoulder wears off after approximately 6 to 18 hours. Patients must take pain relievers during the first few days after surgery. A post-operative follow-up is required two weeks after the procedure to remove the patient’s stitches.
- A splint (provided during surgery) immobilizes the arm and shoulder for three weeks.
- Physiotherapy is critical three to four weeks after surgery.
- Non-physical activities may be resumed the next day if pain levels permit.
- Patients can resume non-strenuous activities during the first week (cooking, driving, writing, typing, school).
- Physical activity may be resumed gradually (varies from one patient to the next).
- Full recovery usually takes between five and six months.
- Success rate: 85% to 95%
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Dr. Marc Beauchamp: the doctor for shoulder and elbow pain