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Shoulder instability - arthroscopic/open stabilisation

Restoring shoulder mobility

Whether you undergo surgical or conservative treatment, our role is to advise on the best course of action, providing you with the means to make an informed decision on how to proceed. Following an accurate diagnosis, we work together with you to clarify the best treatment for your shoulder instability in a detailed discussion.

Conservative therapy

The mainstay of treatment for shoulder instability is appropriately guided physical therapy. This is essential to maintain good scapular position and posture for the shoulder which is the foundation of shoulder movement. By recruiting and strengthening the muscles appropriately around the shoulder, this will help aid centre the humeral head in the glenoid cup, thus improving overall shoulder stability throughout a range of motion.
At Schoen Clinic London, your specialist works as part of a multidisciplinary team to formulate a treatment plan to relieve your symptoms. Conservative treatments focus on a combination of pain management and physical therapy. Part of your rehabilitation will involve modifications to your lifestyle, avoiding activities that are likely to aggravate your condition.

Depending on your individual diagnosis, your specialist will detail different medications and non-surgical options to help resolve your shoulder instability symptoms.

Non-surgical treatment methods

  • Conservative therapy

Surgical treatment methods

  • Arthroscopic shoulder stabilisation

Arthroscopic shoulder stabilisation

Sometimes however when there is a structural lesion in the shoulder, such as a tear or damage to the labral bumper (Bankart lesion) or the shoulder ligaments an operation is required to gain lasting shoulder stability.

The operation is done by arthroscopic, or “keyhole” surgery and usually through two or three 5mm incisions. The minimally invasive procedure involves repairing the over-stretched or torn ligaments deep around the shoulder joint. During arthroscopic procedures, the surgeon creates small incisions and uses an arthroscope (tiny camera) to see the inside of the joint on a video monitor. Using special surgical instruments, the repair involves stitching the torn or stretched ligaments back onto the attachment, to the socket of the shoulder blade (glenoid). This is done using tiny anchors with sutures attached to them. The repair should be protected until healing takes place (four weeks for initial healing).

Sometimes, repair of the soft tissue structures alone is not possible to achieve lasting stability of the shoulder. In these instances, often where there is also significant damage to the bone of the socket or the humeral head, a bone transfer procedure (with or without a tendon attachment) may be required. This is a very robust way of achieving shoulder stability but is often performed as an open procedure rather than a keyhole procedure. During an open procedure the surgeon creates a larger incision at the shoulder, which allows for direct visualisation of the joint.

As with all surgery there is a risk of complications. These are rare, but you should be aware of them before your operation. They include:

  • Complications relating to the anaesthetic
  • Infection
  • Failure to achieve a successful result with further dislocation of the shoulder
  • A need to redo the surgery
  • Injury to the nerves or blood vessels around the shoulder
  • Fracture
  • Prolonged stiffness and or pain
  • Implant failure