Shoulder Stabilization

Understanding Chronic Shoulder Instability:

The shoulder joint is the most flexible joint in our body, making it prone to instability and injury. Chronic shoulder instability occurs when the upper arm bone (humerus) dislocates from its socket (glenoid) due to sudden injury or overuse. Factors such as labrum or rotator cuff tears and ligament damage can contribute to repeated shoulder dislocations.

The Arthroscopic Stabilization Procedure:

Arthroscopic stabilization is a minimally invasive surgical procedure performed through two tiny incisions (portals) around the shoulder joint. Through one incision, an arthroscope—a small fiber-optic viewing instrument—is inserted. This arthroscope transmits live images of the joint’s interior to a television monitor, allowing the surgeon to assess the condition of the cartilage, ligaments, and rotator cuff.

To enhance visibility, a sterile saline solution is pumped into the joint, expanding it for a clearer view. The surgeon then utilizes specialized surgical instruments inserted through the second incision to address any identified issues. Rotator cuff tears are sutured or stapled, and a small anchor is drilled into the upper part of the humerus to secure the sutures. Additionally, a thermal shrinkage device may be used to tighten the ligaments and prevent further instability.

Post-Operative Care and Rehabilitation:

Following arthroscopic stabilization, your surgeon may recommend the use of a continuous passive motion machine to prevent stiffness and improve the range of motion in the shoulder joint. Pain medications will be prescribed to ensure your comfort during the recovery period. Wearing a shoulder sling for 4-6 weeks will immobilize the joint, facilitating healing.

A comprehensive post-operative rehabilitation program, including strengthening exercises, will be advised for 6-9 months. This program aims to restore strength, stability, and functionality to the shoulder joint. Depending on your progress, you may be able to resume sports activities between 18 and 36 weeks after the surgery.

Advantages of Arthroscopic Stabilization:

Arthroscopic shoulder stabilization offers several advantages over open repair techniques. Firstly, it allows surgeons to identify and treat any coexisting diseases or conditions during the procedure. Additionally, patients experience less pain and fewer complications, leading to a shorter hospital stay. The minimally invasive nature of arthroscopy results in smaller incisions, reduced scarring, and faster recovery times.

Potential Risks and Complications:

As with any surgical procedure, arthroscopic shoulder stabilization carries certain risks and potential complications. These include infection at the surgical wound site, post-operative stiffness, the risk of developing arthritis, muscle weakness, and injury to nerves and blood vessels. However, these risks are relatively rare and can be minimized by selecting an experienced surgeon and following post-operative care instructions diligently.

Alternative Procedure: Latarjet Procedure:

In cases of recurrent anterior shoulder instability caused by a bony Bankart lesion, your surgeon may recommend an alternative procedure called the Latarjet procedure. This surgery involves relocating a piece of bone with an attached tendon to the shoulder joint, providing additional stability.