Shoulder Instability: Dislocation or Separation
What Is Shoulder Instability?
Shoulder instability is a condition that results in a loose shoulder joint from injuries such as a shoulder dislocation or a complete shoulder separation resulting in overstretched and damaged tendons and ligaments surrounding the shoulder joint, which make it unstable and prone to further injury.
A shoulder dislocation is an injury that occurs when the ball-and-socket joint, which includes the top of the arm bone (humerus) and the shoulder blade (scapula), loses contact, and the humerus is displaced from the socket. Shoulder dislocations usually occur after an injury such as a fall or a sports-related injury.
A shoulder separation is an injury that results from a separation of the acromioclavicular joint. The “acromion” is the part of the scapula that attaches to the tip of the clavicle (collarbone). A shoulder separation usually occurs from a direct blow to the top of the shoulder or a fall on an outstretched hand.
- Feeling like the shoulder could easily slip out of place (loose joint)
- Shoulder pain (quick bursts, like something slipped or got pinched)
- History of previous shoulder dislocation(s) or injury
- Numbness on the outside of the arm (usually only in complete dislocations when nerves get stretched)
- Possible swelling or bruising in the shoulder area (usually following a shoulder separation)
- Visible abnormalities of the shoulder (it looks displaced or separated)
TREATMENTS FOR SHOULDER INSTABILITY
There are nonsurgical and surgical treatment options available for shoulder instability. Both treatment types are performed by our shoulder specialists at Orthopaedic Specialists.
Some cases of shoulder instability may be treated by splinting, resting, performing stretching or strengthening exercises, avoiding aggravating activities that cause pain, taking anti-inflammatories, and/or receiving corticosteroid injections. While nonsurgical treatment can relieve some cases of the condition, surgery may be necessary.
Arthroscopic Shoulder Instability Repair (Minimally Invasive)
Orthopaedic surgeons Dr. John Hoffman, Dr. Tuvi Mendel, and Dr. Kristyn Darmafall perform arthroscopic shoulder instability repair, which uses small incisions to reattach the damaged tendons and ligaments and stabilize the shoulder joint. Through the incisions, the arthroscope (small video camera) sends enlarged live video footage of the torn or frayed capsular ligaments to a monitor for the surgeon to use as a guide while treating the shoulder instability. The areas of the damaged tendons or ligaments are cleaned up and reattached back in place to the bone, where scar tissue forms and the joint becomes more stable. As a result of the small incisions, patients typically have less downtime and a much faster recovery than patients who undergo open surgical procedures.
Open Shoulder Instability Repair
Traditional open shoulder instability repair procedures require a larger incision than the arthroscopic procedure to reattach the torn capsular ligaments and labrum to the bone.
One option for patients with more significant wear and tear in their shoulder due to recurrent instability is an open procedure using the Latarjet technique. During this procedure, your surgeon will transfer an existing structure in the shoulder blade to replace missing bone in the front of the shoulder joint to restore stability and prevent additional dislocations.