Treatment of the Unstable Shoulder

Shoulder Dislocation

• Most commonly dislocated joint due to lack of bony stability
  

Shoulder Dislocation

• Fast Facts
  50 % of ALL dislocations
  95 % anterior
  85 % caused by trauma recur

  
  

Voluntary or Habitual

• Dislocate at will
• Retrain muscles
• No surgery
• See Psychiatrist
  
  

Conservative Treatment

• Rowe – JBJS, 1957
  324 young patient with ant. dislocations
  94% had recurrence if < 20 years old
  62% had recurrence if < 30 years old
  14% had recurrence if > 40 years old

Natural History

• Non operative treatment of shoulder dislocation
  in young athletes
• Arciera – J Arthroscopy, 1995
  De Beardino – J South Orthopaedic Ass, 1996
  Haelen – J Arch Orthopaedic Trauma Surgery, 1990
  Hovelius – J Orthopaedic Science, 1999
  Wheeler – J Arthroscopy, 1998
  Kirkby – J Arthroscopy, 1999
• all over 80% recurrence rate
  Non operative treatment is unacceptable
  

Arthroscopic Bankart Repair

• Gold standard
  Minimally invasive
  90% success rate
  

Key Hole Surgery

• Minimally invasive
  3 to 4 small holes around your shoulder
  Can be done as a Day Surgery case
  > 90% success rate
  

Early Arthroscopic Stabilisation

• RATIONALE
  - better tissue
  - lesser anatomic damage
• Should avoid:
  - evolution into ALPSA lesion
  - deeper and larger Hill-Sachs lesion
  - capsular elongation
  - evolution into chronic joint instability

Please note that the information contained herein is for general medical information only.
If you have any specific medical condition or queries, please consult your medical doctor.

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