Arthroscopic stabilization of the shoulder is a procedure performed to repair the ligaments and cartilage located in front part of the shoulder using an arthroscope. This surgical procedure is recommended when a shoulder is unstable whereby the shoulder joint has become partially loose (subluxation) or completely separated (dislocation). The instability may cause arthritis with intense pain felt at the joint.
Instability of the shoulder may be caused by the labrum (cartilage band), ligaments and capsule surrounding the shoulder joint (rotator cuff) separating or tearing from the shoulder socket bone, a condition known as Bankart tear or lesion.
Tearing causing instability is more likely to happen among older individuals, and placing braces can assist in reduction of the repeated dislocation.
Signs and Symptoms of Shoulder Instability
Instability of the shoulder caused by Bankart lesion presents various signs and symptoms including:
- Weakness of the arm
- Shoulder feeling loose especially while engaging in some activities
- Shoulder arthritis
- Intense pain on the shoulder
- Recurring shoulder dislocations
- Sensation of the shoulder slipping in and out
- Shrinking and tightening of the shoulder muscle (Muscle spasms)
- Soreness on the affected area
- Visibly impaired shoulder
- Tingling sensation on the hand and/or fingers
- Losing range of motion
What to do If You Experience Shoulder Instability
Before seeking medical attention for shoulder instability, you should:
- Apply an icepack on the affected area to reduce soreness and pain
- Request for medication such as ibuprofen or acetaminophen to relieve the pain
- Do not strain the arm or shoulder with any movements to avoid worsening the injury
Diagnosing Shoulder Instability
For a definitive diagnosis, the orthopedic surgeon will perform a physical examination to identify the dislocation. This is mostly done by touching the joint. An MRI scan is performed to show the injured tissues, and a CT scan done to check the extent of the damaged bones that are not visible in x-ray.
Dislocation of the shoulder may be either anterior (front of the socket) or posterior (back of the socket). A partial loosening or subluxation indicates the stretching of ligaments and capsule which are not separated from the cartilage.
Arthroscopic Stabilization of Shoulder – Surgery for Shoulder Instability
Arthroscopic stabilization of the shoulder is often performed when there is replicating dislocation and a Bankart tear has formed that needs to be repaired/reconstructed. This is recommended at an early stage to avoid loosening or dislocation of the shoulder.
During the procedure, an instrument known as an arthroscope that has a camera attached to it is inserted into the affected area of the shoulder through an incision. There are usually 2-3 incisions made through which the arthroscope and another medical device known as a shaver are inserted to reconstruct the damage.
During the reconstruction, ligaments located at the front part of the shoulder are tightened and mended through thermal shrinkage. An alkaline solution is injected into the joint to dilate it. If there are any identified tears in the rotator cuff they are also stapled. All these are done through the incisions and are guided/monitored by the arthroscope which displays the images on a monitor. When the procedure is complete the incisions are sutured and dressed with a waterproof dressing to avoid soaking the wound.
Arthroscopic stabilization of the shoulder has various pros which include:
- Faster healing process
- Minimal downtime
- Minimal pain
- Other damages can be identified and treated at the same time the procedure
- Lower level of immobility after the procedure
Follow-up treatment options for shoulder instability undertaken after the surgery include:
- Physical therapy
- Rest and avoiding strenuous activities
Possible Complications of Arthroscopic Stabilization of the Shoulder
Just like any other surgical procedure, there may be complications after the arthroscopic stabilization surgery. These include:
- Weakening of the muscles
- Possible damage to the blood vessels and/or nerves.
- Infection of the wound
- Inflexibility of the shoulder and arm
- Chances of developing arthritis.
Post-op Care After Arthroscopic Stabilization
After the arthroscopic stabilization surgery, a sling will be provided to be worn for approximately 6 weeks and a continuous passive motion machine will be used throughout the duration of physical therapy to avoid rigidity of the arm and to regain the range of motion. Other exercises that strengthen the arm and shoulder will be advised on by a physiotherapist.
For pain management and soreness, medication will be administered in the first 24 hours after the procedure, and some oral pain medications will be prescribed for the next 5 days. The dressing will be removed after 2 weeks when the wound has healed.
Normal activities can be resumed after 9 months at most, which is dependent on the healing.
Our board-certified orthopedic surgeons at King’s have extensive knowledge of the full range of shoulder disorders and will help you find the ideal medical solution for your condition. You can get in touch by filling in the form below.
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