Adam Durrant - Durrant Orthopaedics - Hand & Upper Limb Orthopaedic Surgeon
Private Service, Orthopaedics
Shoulder Dislocation and Stabilisation
The shoulder is an inherently unstable "ball and socket" joint. This allows the shoulder to have a wide range of motion, but does mean that it is more at risk of dislocation. Unlike the hip, where boney congruity maintains the stability of the joint, the shoulder relies on soft tissues to hold it in joint.
Dislocation of the shoulder is common, usually anterior, and most commonly due to trauma to the shoulder such as a fall or a mis-timed rugby tackle. Most shoulder dislocations can be reduced without the need for surgery. However, in a young person with a single, traumatic, anterior dislocation, the chances of dislocating again, especially if engaged in contact sports, is greater than 90-95%. Dislocations in other directions are also seen, and can be managed in a similar fashion to anterior ones.
Surgery has an accepted role as a way of stabilising the shoulder to prevent further dislocations. The most common surgery done in my practice is an arthroscopic shoulder stabilisation ("keyhole surgery"). The aim of the surgery is to repair the structures at the front of the joint to "tighten then up" and prevent further dislocations. The success of this surgery is greater than 90%. You may also hear of this surgery referred to as a "Bankhart repair" in reference to the name surgeons give to the damaged tissues at the front of the shoulder.
If there is more substantial damage to the joint then a bigger surgical procedure may be necessary. This usually involves restoring damaged bone at the front of the joint by transferring a tendon-bone block from elsewhere in the shoulder to the front of the joint. This is known as the Laterjet procedure.
For more information regarding shoulder arthroscopy or "keyhole" surgery click here
For more information on shoulder dislocation click here
For more information on shoulder stabilisation click here