The shoulder is strong, but like any other joint, it can get injured or dislocate. You don’t need to be a expect, but understanding your surgical options after a shoulder dislocation can empower you to make the right decision. Not only that but often surgeons don’t get a heap of time to explain what the surgery involves.
Firstly, surgery is very rarely used in a first-time shoulder dislocation. Unless there are other complicating factors, conservative treatment should be the way to go. Surgery is more commonly considered if there is chronic instability, recurrent dislocations, or bony injuries such as a Bankart or Hills Sach’s lesion (more on that later). If you have dislocated your shoulder for the first time, you should really talk to a physiotherapist about getting the right rehab done. Depending on the severity of the injury, this could take between 4- 8 weeks.
Now, onto shoulder surgeries. There are two main surgical options for shoulder dislocations. The first is an anterior stabilization.
This procedure is used when a shoulder dislocation/subluxation has disrupted the anterior ligaments of the shoulder to the point where they are not stabilizing the shoulder. Essentially, a surgeon goes in, tightens up the anterior ligament, along with cleaning up the labrum. This is normally the go-to option on a first-time op, or a uncomplicated shoulder dislocation.
This type of surgery generally has a 3 month recovery process
The 2nd type of operation is called a Latarjet, and its a bit more complex. This surgery is often used when a dislocation or subluxation has caused bony damage either to the rim of the shoulder capsule (Bankart) or to the head of the humerus (Hills Sachs), which will cause chronic instability and pain. The two pictures below demonstrate what these injuries look like
This type of operation is a bit more drastic. It involves taking a part of the coracoid process (a bony landmark that is in your shoulder) and screwing it into the bottom part of the rim of the shoulder. This will physically block the shoulder from going into external rotation. You would usually not get full external rotation back.
This surgery generally has a 6 month time frame to recovery
Understanding what each option involves is important, as it will help you make an informed decision as to what you should do. It is also important to understand that the more drastic the surgery, the longer the recovery time will be.
By Jay Kasthuriarachchi
Physiotherapist
