Shoulder Instability

Shoulder instability is a condition that occurs when the upper arm bone (humerus) is forced out of the shoulder socket (glenoid). This can happen due to a traumatic injury, repetitive overhead motions, or genetic factors. When the shoulder becomes unstable, it can cause pain, weakness, and a feeling of looseness in the joint.

Arthroscopic surgery is a minimally invasive procedure that can be used to treat shoulder instability. During this procedure, a small camera is inserted into the shoulder joint through a small incision. This allows the surgeon to see inside the joint and repair any damage that may be causing instability. Arthroscopic surgery is often preferred over traditional open surgery because it results in less pain, scarring, and a faster recovery time. However, not all cases of shoulder instability require surgery and conservative treatment options such as physical therapy may be recommended first.

Understanding Shoulder Instability

Anatomy of the Shoulder

The shoulder joint is a ball-and-socket joint that allows for a wide range of motion. It is made up of three bones: the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). The head of the humerus fits into the shallow socket of the scapula, which is called the glenoid. The joint is surrounded by a capsule of ligaments, tendons, and muscles that provide stability and support.

Mechanisms of Shoulder Instability

Shoulder instability occurs when the head of the humerus is forced out of the glenoid socket, either partially or completely. This can happen due to a traumatic injury, such as a fall or a blow to the shoulder, or due to repetitive overhead motions, such as those performed by athletes in sports like baseball and volleyball. When the shoulder becomes unstable, it can lead to pain, weakness, and a decreased range of motion.

Types of Shoulder Instability

There are two main types of shoulder instability: anterior and posterior. Anterior instability occurs when the humerus is forced out of the front of the socket, while posterior instability occurs when the humerus is forced out of the back of the socket. Each type of instability can be further classified as either traumatic or atraumatic, depending on the cause of the instability.

In some cases, shoulder instability can be treated with conservative measures such as rest, ice, and physical therapy. However, in cases where conservative treatment is not effective, arthroscopic surgery may be necessary to stabilize the joint and prevent further damage.

Arthroscopic Surgery for Unstable Shoulders

As an orthopedic surgeon, I often recommend arthroscopic surgery for patients with unstable shoulders. This minimally invasive procedure can help stabilize the shoulder joint and reduce pain and discomfort.

Indications for Arthroscopic Surgery

Arthroscopic surgery is typically recommended for patients with recurrent shoulder dislocations or subluxations. These conditions can occur due to a variety of factors, including trauma, overuse, or congenital abnormalities.

Before recommending arthroscopic surgery, I typically conduct a thorough physical examination and imaging studies to confirm the diagnosis and assess the extent of the instability. Patients with significant bone loss or other structural abnormalities may not be good candidates for arthroscopic surgery and may require more extensive procedures.

Arthroscopic Techniques

During arthroscopic surgery, I make small incisions in the shoulder and insert a small camera and specialized instruments to repair and stabilize the joint. The specific technique used will depend on the patient’s individual needs and the extent of the instability.

Some common arthroscopic techniques include:

• Bankart repair: This involves reattaching the torn labrum to the shoulder socket using sutures or anchors.
• Capsular shift: This involves tightening and repositioning the shoulder capsule to improve stability.
• Remplissage: This involves filling in a defect in the humeral head with soft tissue to prevent the shoulder from dislocating.

Arthroscopic surgery for unstable shoulders is typically performed on an outpatient basis, and most patients can return to normal activities within a few weeks. However, recovery time can vary depending on the extent of the surgery and the patient’s individual healing process.

Overall, arthroscopic surgery can be a highly effective treatment option for patients with unstable shoulders. If you are experiencing recurrent shoulder dislocations or subluxations, I recommend consulting with an orthopedic surgeon to determine if arthroscopic surgery is right for you.