Shoulder dislocations are normally caused by a traumatic injury, such as a fall from a height, tripping and landing heavily onto the shoulder, or by a hard blow, such as a high-speed collision. When the shoulder dislocates the upper arm bone (humerus) pops out of the socket in your shoulder joint, often causing extensive damage to the surrounding soft tissues. A dislocated shoulder is a very painful injury and because the shoulder is the most mobile joint in the body there is a risk of repeated dislocations if the joint becomes unstable.
Read our blog Do I Need Surgery After a Shoulder Dislocation? to find out more about the causes, symptoms and possible treatments for a dislocated shoulder, including non-surgical options.
Surgery for a dislocated shoulder
Surgery is normally only recommended for a dislocated shoulder if other less invasive options have been tried or if the injury is severe with a fracture or the joint has become extremely unstable and very prone to repeated dislocation. There are a number of possible surgical procedures and the orthopaedic surgeon will make a recommendation depending on your age and activity level; how badly damaged the shoulder joint is (including injuries to the bone, cartilage, tendons and ligaments; and the direction of the dislocation.
Types of surgical repair
Among the most common types of surgery for a dislocated shoulder are:
- Bankart repair: A Bankart lesion occurs when the ring of cartilage that surrounds the shoulder socket (the labrum) is torn away as the shoulder dislocates. A Bankart repair is used to repair the damaged labrum and reattach it to the socket. It is usually done arthroscopically (using keyhole surgery) or using a traditional open surgery approach in cases where keyhole surgery is not an option.
- Latarjet procedure: Sometimes also called a Bristow-Latarjet procedure, the technique is used when there is extensive bone damage in the joint or when keyhole surgery has not worked. The Latarjet procedure involves moving bone from the front part of the shoulder blade (the coracoid process) onto the front edge of the shoulder socket to make it wider. It is a very successful procedure because the tendon attached to the coracoid process is transferred as well, adding extra reinforcement to the front of the joint.
- Remplissage procedure: If you have a Hill-Sachs lesion, which is severe damage to the head of the humerus bone, but not too much damage to the bone socket, the surgeon may perform a remplissage procedure alongside the Bankart repair. This is done with a keyhole technique that involves filling the defect in the humeral head with part of the rotator cuff.
- Capsular shift: This procedure is used after multiple shoulder dislocations when the labrum has become extremely worn away. It involves tightening up the ligaments that hold the shoulder joint in place which may have become loose and stretched over time.
- Rotator cuff repair: This procedure is much more common in people aged over 40 who dislocate their shoulder and the rotator cuff tear has resulted in significant pain and weakness. In most cases the repair can be done with a keyhole technique. In much older people there can be a very extensive pre-existing rotator cuff tear that extends with an injury. Sometimes it not possible to repair the tear and in extreme cases a certain type of shoulder replacement called a reverse prosthesis is needed.
Whatever type of surgery you have, proper rehabilitation is important to ensure you recover well and regain use of your shoulder joint. Every patient undergoing surgery with Thames Shoulder and Elbow is given a detailed post-operative rehabilitation protocol to follow to restore function and flexibility to their joint.
If you have a suspected shoulder dislocation it is important to seek medical help quickly. We will be happy to discuss whether surgery is appropriate in your case and, if so, which surgical procedure would be the best for you.
Orthopaedic Consultant & Surgeon | London
If you sustain an injury such as a shoulder dislocation, it is important to seek professional help. An orthopaedic surgeon can provide an accurate diagnosis and recommend the most effective type of treatment, which may include surgery.
Contact us to speak to a shoulder and elbow specialist who can outline your options.
Telephone: 020 376 15987