Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery : (315) 251-3100
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Patient Education

Shoulder Instability/Labral Repair

Shoulder Instability

Shoulder instability is a chronic condition that causes frequent dislocations of the shoulder joint. A dislocation occurs when the end of the humerus (the ball portion) partially or completely dislocates from the glenoid (the socket portion) of the shoulder. A partial dislocation is referred to as a subluxation whereas a complete separation is referred to as a dislocation. The common symptoms of shoulder instability include pain with certain movements of the shoulder; popping or grinding sound may be heard or felt, swelling and bruising of the shoulder may be seen immediately following subluxation or dislocation. Visible deformity and loss of function of the shoulder occurs after subluxation or sensation changes such as numbness or even partial paralysis can occur below the dislocation as a result of pressure on nerves and blood vessels.

The risk factors that increase the chances of developing shoulder instability include:

  • Injury or trauma to the shoulder
  • Falling on an outstretched hand
  • Repetitive overhead sports such as baseball, swimming, volleyball, or weightlifting
  • Loose shoulder ligaments or an enlarged capsule.

Treatment

The goal of conservative treatment for shoulder instability is to restore stability, strength, and full range of motion. Conservative treatment measures may include the following:

  • Closed Reduction: Following a dislocation, your orthopaedist can often manipulate the shoulder joint, usually under anesthesia, realigning it into proper position. Surgery may be necessary to restore normal function depending on your situation.
  • Medications: Over the counter pain medications and NSAID’s can help reduce the pain and swelling. Steroidal injections may also be administered to decrease swelling.
  • Rest: Rest the injured shoulder and avoid activities that require overhead motion. A sling may be worn for 2 weeks to facilitate healing.
  • Ice: Ice packs should be applied to the affected area for 20 minutes every hour.

When these conservative treatment options fail to relieve shoulder instability, your surgeon may recommend shoulder stabilization surgery. Shoulder stabilization surgery is done to improve stability and function to the shoulder joint and prevent recurrent dislocations. It can be performed arthroscopically, depending on your particular situation, with much smaller incisions. Arthroscopy is a surgical procedure in which an arthroscope, a small flexible tube with a light and video camera at the end, is inserted into a joint to evaluate and treat of the condition. The benefits of arthroscopy compared to the alternative, open shoulder surgery are smaller incisions, minimal soft tissue trauma, less pain leading to faster recovery.

Labral Tear

The shoulder is a “ball and socket” joint but is inherently unstable because of its shallow socket. A soft rim of cartilage called the labrum lines the socket and deepens it so that it accommodates the head of the upper arm bone better. In other words, the labrum helps stabilize the joint and serves as a site of attachment for several ligaments.

Traumatic injury to the shoulder or repetitive shoulder movements (throwing, weightlifting) may cause labral tear. As we age, the labrum may weaken and become susceptible to injury. Shoulder labral tear injury may cause symptoms such as pain, catching or locking sensation, decreased range of motion and joint instability.

Your doctor will prescribe anti-inflammatory medications and advise rest to relieve symptoms until diagnostic scans are done. Rehabilitation exercises may be recommended to strengthen rotator cuff muscles. If the symptoms do not resolve with these conservative measures, your doctor may recommend arthroscopic surgery.

During arthroscopic surgery, your surgeon examines the labrum and the biceps tendon. If the damage is confined to the labrum without involving the tendon, then the torn flap of the labrum will be removed. In cases where the tendon is also involved or if there is detachment of the tendon, absorbable wires or sutures will be used to repair and reattach the tendon. After the surgery, you will be given a shoulder sling to wear for 3-4 weeks. You will be advised motion and flexibility exercises after the sling is removed.

Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery
Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery
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Syracuse Orthopedic Specialists American Association of Orthopaedic Surgeons
The American Orthopaedic Society for Sports Medicine
Arthroscopy Association of North America
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