The most common type of dislocation is an anterior dislocation where the shoulder displaces to the front. In these cases, the labrum (cartilage support) on the front of the socket is often torn from its bone attachment.
Reattachment of the labrum to the front of the shoulder socket can often be performed as an arthroscopic (key hole) procedure.
The patient undergoes a general anaesthetic. Intravenous antibiotics are given to reduce the risk of infection.
A small incision is made at the back of the shoulder joint. This allows the camera to be inserted into the shoulder to inspect the damage. Two further portals are then inserted at the front of the shoulder joint. These allow instruments to be passed into the shoulder joint.
The damaged labrum is freed up from any scar tissue and it is reduced into its normal position. A small drill hole is made in the front of the socket. An anchor is placed into the drill hole with a suture passed around the labrum pulling it back into position at the edge of the socket. Usually two or three anchors will be placed along the rim of the socket to reattach the cartilage.
During the procedure, the shoulder is distended by pumping fluid into the joint. This can result in some swelling of the shoulder girdle region. Wounds are closed with absorbable sutures.
Following surgery, most patients remain in hospital overnight for analgesia if needed. Patients are placed in a sling to provide protection. Movement is limited for the first six weeks to prevent any tearing to the repair site.
In cases of recurrent instability or in situations where there is deficiency of the size of the socket, more significant bone procedures may be required to provide stability.