Shoulder Stabilisation Surgery

Shoulder stabilisation surgery is a surgical procedure performed to repair and stabilise the shoulder joint, typically after a dislocation or recurrent instability. The goal of the surgery is to restore stability and prevent future dislocations.

Indications for Surgery

• Recurrent shoulder dislocations or subluxations (partial dislocations)
• Shoulder instability due to trauma, sports injuries, or congenital conditions
• Failed conservative treatment, such as physical therapy and bracing
• Labral tears or Bankart lesions (damage to the labrum, a cartilage ring that surrounds the socket of the shoulder joint)

Surgical Techniques

There are several surgical techniques used for shoulder stabilisation surgery, including:

• Open Bankart repair: An open surgical procedure where an incision is made to access the shoulder joint and repair the labrum and surrounding tissues.
• Arthroscopic Bankart repair: A minimally invasive procedure where a small camera (arthroscope) and instruments are inserted through tiny incisions to repair the labrum and surrounding tissues.
• Latarjet procedure: A surgical procedure that involves transferring a piece of bone from the coracoid process to the front of the glenoid (socket) to enhance stability.
• Bristow procedure: A surgical procedure that involves transferring a piece of bone from the coracoid process to the front of the glenoid, similar to the Latarjet procedure.

Surgical Steps

1. The patient is positioned in a beach chair or lateral decubitus position, depending on the surgical approach.
2. A general anaesthetic is administered, and the shoulder area is cleaned and draped.
3. An incision is made, either open or arthroscopic, to access the shoulder joint.
4. The labrum and surrounding tissues are inspected and repaired using sutures, anchors, or other fixation devices.
5. Any additional procedures, such as bone grafting or tendon transfers, may be performed as needed.
6. The incision is closed, and the shoulder is immobilised in a sling or brace.

Post-Operative Care and Rehabilitation

After surgery, patients typically follow a rehabilitation protocol that includes:

• Pain management with medication and ice
• Immobilisation in a sling or brace for 4-6 weeks
• Gradual range of motion exercises, starting with passive movements and progressing to active movements
• Strengthening exercises, focusing on the rotator cuff and scapular stabilisers
• Progressive resistance exercises and functional activities, such as throwing or lifting

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with shoulder stabilisation surgery, including:

• Infection
• Bleeding or haematoma
• Nerve damage or numbness
• Stiffness or limited range of motion
• Recurrence of instability or dislocation

Outcomes and Prognosis

The outcome of shoulder stabilisation surgery is generally excellent, with high success rates in terms of restoring stability and preventing future dislocations. However, the prognosis may vary depending on individual factors, such as:

• Severity of the initial injury or condition
• Presence of any underlying conditions, such as osteoarthritis or rotator cuff disease
• Adherence to post-operative rehabilitation protocols
• Overall health and fitness level