Introduction
The aim of surgery is to minimise the risk of future recurrent dislocations.
Indications
Surgery is performed in anyone who wants to reduce/eliminate chances of further dislocation and damage in the shoulder.
The two most commonly performed surgeries are Arthroscopic shoulder stabilisation surgery and Latarjet procedure
Arthroscopic shoulder stabilisation / Bankart Repair
This is the most commonly performed surgery and can be referred to as bankart or labrum repair surgery.
The surgery is performed under general anaesthesia. The surgery is performed arthroscopically using 2 or 3 small incisions (3-5mm). A camera and an instrument is inserted through these incisions into the shoulder joint.
In this surgery, the torn labrum is identified, freed up and repaired back to the glenoid rim using suture anchors.
The surgery takes approximately 1 hour.
Recovery
- 1-night stay in hospital.
- First 6 weeks in sling.
- Rehab programme with physio.
- Return to sport at 6-9 months.
Results
The incidence of recurrent instability is 5-15% depending on patient risk factors.
Risks and complications
These include:
- Recurrent instability.
- Stiffness.
- Nerve injury.
Latarjet procedure
This procedure is reserved for more complex cases:
- Bone erosion of the socket as a result of recurrent instability.
- Elite athletes in contact sports.
- Failed arthroscopic stabilisation surgery.
The Latarjet procedure involves using the coracoid bone (which is attached to the top of the glenoid socket) as a bone graft and fixing it to the deficient front of glenoid to make up for the eroded bone.
The bone graft is fixed with 2 screws.
The surgery is performed under general anaesthesia. A 4-5cm single incision is made at the front of the shoulder.
Recovery
- 1-night stay in hospital.
- First 6 weeks in sling.
- Rehab programme with physio.
- Return to sport at 4-6 months.
Results
Latarjet procedure has a recurrent dislocation rate of approximately 5%
Risks and complications
These include:
- Recurrent instability / dislocation.
- Stiffness.
- Fracture.
- Irritation from screws.
- Nerve / Blood vessel injury.