Shoulder Instability Surgery

Definition of shoulder instability:

Instability may be a dislocation or subluxation. A dislocation is when the “ball” comes completely out of the “socket.” It may be out for only seconds or longer. It may become lodged out of the joint and require treatment at an emergency room to reinsert. Subluxation is when the “ball” comes only partially out of the “socket.” It returns spontaneously into the socket. Dislocation is a more serious form of instability than subluxation. The shoulder is the most mobile joint in the body and instability is common. Dislocation is usually caused by trauma. Subluxation may occur without trauma. Subluxation may occur in athletes whose shoulder becomes stretched in their sport, such as baseball pitchers or swimmers.

Treatment:

Tightening or repair of the shoulder ligaments can be performed arthroscopically. While it is often successful, the results so far have not been as good as traditional open surgery using an incision. Treatment involves repair of the glenoid labrum (a lip of rubbery tissue attaching to the shoulder socket). The capsule may also be sutured to tighten it or it may be pulled upward to take up slack. Thermal capsular shrinkage may also be employed to tighten the shoulder ligaments. This process uses energy in the form of heat imparted by a variety of instruments to shrink the capsule and tighten the shoulder. This generally is used to “fine tune” a minor amount of shoulder looseness. Permanent damage to the shoulder ligaments has been reported from using thermal capsular shrinkage.