Shoulder Stabilization Surgery

Shoulder stabilization surgery is a procedure designed to restore stability to the shoulder joint, which is susceptible to dislocations and recurrent injuries. This surgery typically involves repairing any damaged ligaments or tendons that contribute to instability, often utilising techniques such as arthroscopy or open surgery. Patients may present with symptoms like pain, weakness, or a feeling of the shoulder "giving out." Post-surgery, a structured rehabilitation program is crucial to regain strength and mobility, ultimately aiming to return the individual to their desired level of physical activity. The surgical approach selected depends on the specific nature and extent of the shoulder injury, as well as the patient's overall health and activity goals.

a 3D illustration of a knotless shoulder labral repair with Arthrex® PushLock® technology

Step-by-Step Breakdown of Shoulder Stabilization Surgery

  1. Preoperative Assessment

    • Comprehensive evaluation of the patient's medical history.

      Physical examination and imaging studies, such as MRI or X-rays, to assess the extent of shoulder instability.

  2. Positioning and Anaesthesia

    • The patient is positioned comfortably on the operating table.

    • General anaesthesia or regional anaesthesia (interscalene block) is administered to ensure comfort and pain control during the procedure.

  3. Surgical Approach

    • A surgical incision is made, typically on the front or side of the shoulder, in an area that will minimize scarring.

  4. Exploration of the Joint

    • The surgeon carefully dissects through the soft tissues to access the shoulder joint.

    • Identification of the glenoid (the socket of the shoulder joint) and the surrounding ligaments and tendons.

  5. Labral Repair (if applicable)

    • Examination of the labrum, a cartilage ring encircling the glenoid.

    • If the labrum is torn, the surgeon uses sutures or anchors to reattach the labrum to its original position.

  6. Capsular Tightening

    • The surgeon assesses the shoulder capsule, which may be loose in cases of instability.

    • Techniques such as thermal capsulorrhaphy or plication are used to tighten the capsule.

  7. Stabilization Techniques

    • Depending on the type of instability, the surgeon may use various techniques to stabilize the shoulder. This can include:

      • Bankart repair for anterior instability.

      • Latarjet procedure for individuals with significant bone loss.

  8. Closure

    • After completing the stabilization techniques, the surgeon ensures that all structures are properly aligned.

    • The incision is closed using sutures or staples, with attention to cosmetic results.

  9. Postoperative Care

    • The patient is moved to a recovery area for monitoring.

    • A sling is applied to immobilize the shoulder, and pain management protocols are initiated.

  10. Rehabilitation

    • A structured rehabilitation program is developed, which typically starts with gentle range-of-motion exercises.

    • Gradual progression to strengthening exercises is implemented based on healing and recovery goals.

  11. Follow-Up Appointments

    • Regular follow-up visits are scheduled to monitor healing, evaluate shoulder function, and adapt the rehabilitation program as necessary.

This straightforward outline covers the fundamental steps in shoulder stabilization surgery. Each case may require specific adjustments based on individual circumstances.