What is shoulder instability?
Shoulder instability is a cause of serious shoulder pain. When the shoulder dislocates, the ball comes completely out of the socket. With subluxation (or instability), the ball only partially displaces from the socket. If this occurs, the patient will experience pain and inability to use the shoulder. With shoulder instability, there is damage to the shoulder ligaments that keep the ball fixed within the socket.
What causes shoulder instability?
Usually, the shoulder ligaments tear as the result of a single violent injury or some form of blunt trauma. This can occur during a motor vehicle accident or football tackle.
There is a second cause of instability, which is called Multidirectional Instability (MDI). This is a result of congenitally weak soft tissue stabilizing structures around the shoulder. Thankfully, MDI can often be treated successfully without surgery by physical therapy.
How would I know my shoulder was unstable?
If you have shoulder instability, you will experience pain in the shoulder region and often have a subtle feeling of the shoulder “slipping” during use. Many people complain when raising the arm above the head.
Will I need x-ray or some of the diagnostic test if this occurs?
If the Phoenix orthopedic specialist suspects shoulder instability, he may order x-rays or
Bankart Lesion
schedule a magnetic resonance imaging (MRI) test. This will help to confirm the tear of the ligament from the bone, which is called a Bankart lesion. Also, the labrum can be torn, and this structure is necessary to attach ligaments with bone.
If there is a suspected Bankart lesion due to trauma, then a CT scan can show the intricacies of the fracture.
What are the various treatment options for shoulder instability?
If your orthopedic doctor in Phoenix diagnoses this condition, he will determine the treatment based on your age, the extent of the injury, and what your activity level is or was before the injury. If dislocation occurs, the specialist will need to reposition the bone back into the socket, and many times, surgery is necessary to repair torn ligaments and the labrum.
As mentioned, if the instability is not due to trauma, but rather is a multidirectional problem, then physical therapy may work well. Traumatic dislocations that lead to subsequent instability typically do not respond well to physical therapy.
What can I expect with shoulder instability surgery?
If shoulder instability occurs, the orthopedic surgeon can use arthroscopic procedures. This involves inserting a small camera (called an arthroscope) through small incisions around the shoulder region. This allows the sports medicine doctor to view the inside of the shoulder on a TV monitor and make needed repairs. Small instruments are inserted through other tiny incisions so the Phoenix orthopedic surgeon can remove, reconstruct, and repair damaged structures and tissues.
The surgeon often must use suture anchors which have sutures attached. These hold ligaments in place. If the damage is longstanding or serious, the orthopedic specialist may need to perform open surgery.
What are the complications of this type of surgery?
Complications from arthroscopic surgery are uncommon, but they do occur. The risks associated with this include shoulder stiffness, infection, nerve damage, and bleeding.
Will I be put to sleep for the arthroscopic shoulder instability repair procedure?
The type of anesthesia used will depend on the patient’s preference, the Scottsdale orthopedic surgeon’s choice, and the type of surgery. With general anesthesia, the patient is unconscious during the procedure. If regional anesthesia is used, the patient is awake, but the entire shoulder area will be numbed.
For instability surgery, patients are typically put “out” for the procedure with general anesthesia.
What happens after the surgery?
Once you have the operation, you will be give specific instructions for home care and follow-up. Pain medication is often prescribed, and you will be placed in a sling. The dressing will not be removed for around 4 to 7 days following surgery, so you can only bathe, not shower. The stitches will come out around one week after the procedure, during your follow-up visit.
Will I need physical rehabilitation?
Most patients require physical therapy following a shoulder surgery to repair instability. This allows the tissue to heal, assists with regaining motion and strength, and helps you get ready to return to sports play.
What is the success rate of arthroscopic shoulder instability surgery?
The success rate for this type of surgery varies, but is typically around 90 to 95 percent successful for regaining a fully stable shoulder.
Dr. Sumit Dewanjee is a first rate Phoenix shoulder surgeon who is Board Certified and has Fellowship Training in sports medicine procedures. This includes all types of shoulder instability procedures including arthroscopic SLAP lesion repair.
Most insurance is accepted at FXRX, call (480) 449-3979 today for more information and scheduling with one of the best shoulder surgeons Phoenix trusts!
References:
Mazzocca AD, Cote MP, Solovyova O, Rizvi SH, Mostofi A, Arciero RA.
http://www.ncbi.nlm.nih.gov/21566068
Zhao J, Huangfu X, Yang X, Xie G, Xu C.
http://www.ncbi.nlm.nih.gov/24510068
Sodl JF, McGarry MH, Campbell ST, Tibone JE, Lee TQ
http://www.ncbi.nlm.nih.gov/24509881
