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Shoulder Instability

Shoulder Instability

shoulder-dislocation

Shoulder instability refers to a condition where the structures surrounding the shoulder joint are unable to maintain its proper position, leading to frequent dislocations or subluxations.

Shoulder is the most common joint in the body to dislocate. Due to its ball and socket design we have a great deal of mobility within the shoulder, which is directly at the cost of stability.

Shoulder joint socket is formed by bony glenoid and labrum attached to it, while ball is formed by head of humerus (arm bone).  Shoulder dislocates anteriorly far more commonly than posterior. Glenoid labrum is crucial stabilizing factor that tears when shoulder dislocates. It is known as Bankart tear or Bankart lesion. When shoulder dislocates it leads to cuticle depression injury on posterolateral portion of head of humerus known as Hill sach’s lesion.

Treatment

  • Acute shoulder dislocation needs to be reduced by orthopaedic surgeon under suitable anaesthesia.
  • Rest in sling, ice , medicines and physical therapy are important
  • In recurrent shoulder instability surgical intervention is needed depending on age, dislocations and bone loss.
  • Arthroscopic Bankart  repair – it is a keyhole surgery where anterior labrum can be repaired to glenoid with the help of suture anchors.
  • Latarjet procedure – this procedure is required if significant bone loss is present. Coracoids process (part of bone scapula) along with its muscle attached is fixed to glenoid rim.