Shoulder Instability Surgery

Your age, activity level, and the extent of your injury will help your shoulder surgeon determine what type of surgery is best for you. Most procedures are performed using an arthroscope, a tiny camera that is inserted through small incisions into the shoulder joint. Shoulder arthroscopy is a minimally invasive procedure that results in minimal pain. Open stabilization surgery, which requires larger incisions, may be necessary if you have a complex shoulder problem or are at high risk for recurrent instability.

Bankart Repair
Also known as arthroscopic labral repair, this common procedure repairs tears to the labrum -- the ring of cartilage around the edge of your shoulder socket. It restores stability to shoulders that don’t have extensive damage from repeated dislocations. Arthroscopic repairs can be performed at both the front and back of the shoulder depending on which direction your shoulder dislocated. If there is extensive injury to the front of the labrum or the bone of the socket joint or you are at high risk for recurrence, your doctor may recommend an open Bankart repair.

Remplissage Technique
Sometimes, a dislocated shoulder can result in a dent in the ball part of the joint -- which can cause the shoulder to dislocate again. This arthroscopic procedure fills in the dent in the back of the ball part of the joint by advancing part of the attachment of the rotator cuff into that area, reducing your risk of future dislocations. This may be combined with a Bankart repair.

Latarjet Technique for Shoulder Instability
The bone at the front of the shoulder socket can become chipped or worn away from repeated dislocations. Your shoulder surgeon may use this technique to transfer a piece of bone (the coracoid) and tendon from another part of your shoulder and attach them to the damaged area. Together they keep the ball at the top of your upper-arm bone from slipping out of your shoulder socket.

Other Bone Grafts
Large bone defects on the front of the socket can also be repaired with donor bone and cartilage, bone taken from your pelvis, or bone taken from the end of your collar bone.

Is the Surgery an Outpatient Procedure?
Yes, the surgery is typically performed on an outpatient basis, and you can go home the same day.

How Long Does the Surgery Take?
The procedure can take one to two hours, depending on how complex it is.

Is Shoulder Instability Surgery Painful?
You shouldn’t feel any pain during the procedure. Before the surgery, the anesthesia doctor will use ultrasound to inject numbing medication around your nerves to provide a regional nerve block. The medication numbs the area from your neck down through your arm. The doctor may also give you a sedative to help you sleep through the procedure.

How Long Does Pain Last After Surgery?
The regional nerve block can be short- or long-acting and lasts 18 to 72 hours. Your doctor will also recommend over-the-counter medications, which will keep your pain to a minimum as the nerve block wears off. An ice water cooling sleeve will also help with pain at night. Following your doctor's instructions for pain management will help minimize need for narcotic pain medication. Most people do not need pain medication after the first few days.

What Is the Recovery Time for Shoulder Instability Surgery?
How much time your recovery and rehab take will depend on several factors, including the severity of your injury, how long you had or how often you have had shoulder instability before surgery, and how well you stick with physical therapy appointments and exercises.

How Soon Will I Start Physical Therapy?
You’ll likely start physical therapy within a week after shoulder instability surgery. Over the next 16 weeks or so, you’ll gradually progress from assisted movement (your physical therapist or your good arm moving your affected shoulder) to light resistance exercises, to strengthening exercises. During the first four to six weeks, limits on range of motion may be used to protect your repair.

How Soon After Shoulder Instability Surgery Can I Drive?
You can usually start to drive at six weeks.

What Other Activity Limits Will I Have?
You should limit heavy lifting until 12 weeks. You should not play contact sports or do Olympic-style weightlifting until 16 weeks after surgery. 

How Soon Can I Return to Sports?
If you’re an athlete, our sports physical therapists can tailor exercises to help you return to your sport safely, maximize your performance, and reduce your risk of re-injury. Full rehabilitation may take four to six months based on the sport. Depending on your level of play, you may also undergo functional return-to-sport strength testing for sports clearance.