The shoulder is a ball and socket joint. This ball and socket is different from the hip, which has a very large ball, and a deep socket, in that the shoulder is more like a golf ball on a golf tee. When the ball falls off of the tee, it is considered dislocated. The ball typically dislocates out the front of the socket when the arm is in a position away from the body, but it may also dislocate toward the back. Once the shoulder has dislocated one time it is prone to dislocate again.
Patients who have suffered a shoulder dislocation who need shoulder dislocation surgery typically come to the clinic after a fall. Oftentimes they fall with their arm up and away from their body and have been to the Emergency room, where they may have had their shoulder put back into place. Patients experience swelling and bruising around the shoulder. Many patients will dislocate their shoulder repeatedly, and may even be able to put it back into place on their own. These patients are considered chronic dislocators.
The shoulder is a shallow ball and socket joint with surrounding cartilage, ligaments, and muscles, which add to its stability. One of the most common shoulder injuries, resulting in a dislocation, is an injury to the labrum. The labrum acts as a bumper, on the front of the socket. When this becomes separated, the socket is disrupted and the ligaments stabilizing the shoulder are detached, causing further shoulder instability. An injury to the labrum is called a bankart tear, or bankart lesion.
The first process in treatment of a shoulder dislocation is for the ball to be put back into the socket. This typically occurs in the emergency room. After that we can decide if shoulder dislocation surgery is the best treatment option, or if physical therapy is all that is needed. Factors which influence this decision include age, sex, the type of injury, and if the shoulder has dislocated in the past. Typically, young male patients are at the highest risk of re-dislocating, and thus we usually recommend shoulder dislocation surgery for these patients to avoid further shoulder instability. Surgical management of a bankart lesion is done arthroscopically through a few small openings in the skin to allow a camera and surgical instruments to be inserted into the shoulder. Using sutures and ties, the labrum and surrounding soft tissues are repaired back to the socket. This is called a Bankart repair.
Recovery after a shoulder dislocation will depend on whether surgery was involved in your treatment. For non-surgical treatment a sling is worn for 2-3 weeks to allow the shoulder to heal. At that time physical therapy begins to help strengthen the surrounding soft tissues. Most patients are back to most activities after four months of treatment with non-operative treatment of a shoulder dislocation. Occasionally we will recommend a brace to prevent further dislocation episodes. After surgical treatment, or bankart repair, the shoulder is placed in a sling for the first month. Depending upon our repair, therapy will begin at that time. Therapy after bankart repair can progress quickly, and most patients are back to full activity by 6 months.
If you have suffered from shoulder dislocation and can be seen are considering shoulder dislocation surgery in the Edwards, Vail or Frisco Colorado areas, request a consultation here to learn more about treatment options for a dislocated shoulder.