Chronic shoulder instability that occurs when the shoulder's internal structures cannot keep the ball in its socket can lead to a great deal of pain. When the joint is too loose, it may shift out of position, which is a condition we refer to as subluxation causing shoulder instability. In addition, the shoulder joint's lining (capsule) or labrum may overly stretch and tear.
There are a number of arthroscopic procedures that are performed to treat chronic shoulder instability. The patient’s age and sporting activities are considered before surgery is planned. The most common instability is an anterior (to the front of the joint) instability. Arthroscopic Bankart Repair, where the cartilage and soft tissue are reattached to the socket's front part, is a common procedure. People participating in a contact sport, especially rugby players, might require a bone and tendon restraint in the front of the joint. This is called a Latarjet procedure. Multidirectional and posterior (back of the joint) instabilities are relatively rare, and although non-operative treatment usually suffices, surgery might be needed occasionally.
A Latarjet procedure is performed on the shoulder when there is a loss of bone of the socket caused by repeated dislocations. In addition, large bone indentations called Hill Sachs lesions at the back of the humeral head may also be present and warrant a Latarjet procedure. The procedure is not performed arthroscopically and is performed through open surgery. During the procedure, I will remove a small piece of bone from part of the shoulder called the coracoid process and place it into the area of the shoulder socket where the bone has been worn away. This piece of bone is attached to the shoulder socket with the use of metal screws. The bone graft acts as a barrier to prevent the shoulder from slipping out of its socket.
The Latarjet procedure is a type of surgery that treats an unstable, partially dislocated shoulder. If you cannot use your shoulder due to pain or as a result of dislocation, you will benefit from Latarjet surgery. This open procedure is used to modify the glenoid with the bone to secure the humerus head within the shoulder’s socket.
Many minor injuries heal without treatment. A full dislocation is a complete disruption ball and socket. This should be reclosed as soon as possible. Shoulder instability and subluxation symptoms are quite similar, and only a medical professional can distinguish between these conditions.
Yes, it is mandatory to protect the shoulder until the soft tissue attachment or bone attachment has healed onto the socket of the shoulder.