Shoulder Dislocation Surgery
– Treatment of Shoulder Joint Instability

What are shoulder joint instability and shoulder dislocation?

The shoulder joint is one of the most complex joints in the human body, providing the arm with a high degree of mobility and flexibility. However, this wide range of motion presents a higher risk factor for injuries.
The complexity and vulnerability of the joint often lead to shoulder joint laxity and shoulder dislocation.

• Shoulder joint laxity, or shoulder instability, is most often based on genetic factors, but trauma can also be the cause. Shoulder instability means that the shoulder joint does not properly hold the humerus, which can lead to dislocations or subluxations. This displacement, as mentioned, can be complete or partial.
• Shoulder dislocation is a very painful condition. In this state, the head of the humerus moves out of its place, or socket. This displacement can be complete or partial.
• In cases of general shoulder instability, the head of the humerus does not completely leave the socket. The patient feels that their muscles are weak, and an uncomfortable, unstable sensation may occur during overhead movements. Frequent accompanying symptoms include pain, mild swelling, and a clicking sound. These symptoms are particularly common in individuals with loose connective tissue.

Shoulder dislocation is an extremely painful condition, and its symptoms are visible. Due to the displacement, the patient adopts a forced posture. The affected limb cannot be moved at all. In this state, even walking and performing simple movements cause extremely severe pain. In the event of a shoulder dislocation, prompt medical attention is essential.

Types of Shoulder Dislocations – Which are the most common?

Shoulder instability can be caused by several factors:

• Traumatic injuries, such as falls or sports accidents, directly affect the shoulder. Traumatic events can cause shoulder dislocation, and the soft tissues of the joint can also suffer severe injury, e.g., muscle rupture, cartilage detachment.
  Repetitive, strenuous overhead movements can gradually damage the joint, leading to inflammation and various unstable conditions.
• Genetic predisposition and anatomical abnormalities can also be underlying causes, increasing the risk of shoulder dislocations. In such cases, the joint capsule is composed of connective tissue that is slightly more elastic and looser than average. Individuals with this type of genetic trait are more prone to subluxations.
• There is also a third type of shoulder dislocation. In this case, some muscles of the rotator cuff do not function properly. During muscle use, their spontaneous contraction and relaxation do not occur, which can lead to posterior dislocation of the shoulder. This type of dislocation is activated by certain movements and arm positions.

How can shoulder dislocation be treated?

Depending on their type, different treatment protocols are warranted. In cases of shoulder dislocation, the most important aspect is to reposition the displaced limb as soon as possible. Repositioning is always performed by a physician. It is not advisable to attempt repositioning at home, as this could cause further harm.

• First, an X-ray of the dislocated shoulder is taken.
• Based on this, the physician diagnoses whether only a minor displacement has occurred or if surrounding tissues are also injured. They check for ruptures in muscles or ligaments, cartilage fractures, or bone damage.
• If there is no serious tissue damage, manual repositioning is performed. In this case, it is very important for the patient to relax their muscles and entire body as much as possible. A pain-relieving injection may be administered for this purpose. If the patient is still unable to relax their muscles, the limb’s position is restored under anesthesia.
• In cases of more severe injury (fracture, rupture), surgical treatment of shoulder dislocation is necessary.
• Shoulder stabilization surgery can be performed via open incision, but it is most commonly done using an arthroscopic method.
• The operation can also be an ideal solution for recurrent shoulder dislocations.
• The operation can be an ideal solution not only in traumatic cases but also for recurrent shoulder dislocations.
• In all cases, the goal is to prevent repeated dislocations and restore the healthy functions of the shoulder joint.

Post-operative Physiotherapy for Shoulder Dislocation Surgery

Physiotherapy is crucial for recovery after shoulder dislocation surgery. An individualized physiotherapy program designed with the help of an expert physiotherapist helps restore shoulder movement, strength, and functionality.

It is essential not to start moving the limb independently after a shoulder dislocation (whether after shoulder dislocation surgery or conservative therapy). Incorrectly performed movements do more harm than good.
A physiotherapist knows exactly how to facilitate the most optimal recovery. In addition to mobilization exercises, optimal strengthening is also necessary, but one must be very mindful to regain healthy functions.
Depending on the condition, physiotherapy sessions not only involve exercises but also manual techniques and physical therapy tools may be used by the physiotherapist, e.g., laser therapy, shockwave therapy, or TR therapy.
It is extremely important that the therapist always uses the most relevant treatment method, which is individually adapted to the patient’s problem.

Most common complaints treated by our shoulder specialists:

• shoulder pain
  
• shoulder dislocation
  
• dislocated shoulder
  
• shoulder muscle and ligament rupture
  
• shoulder muscle pain
  
• shoulder inflammation
  
• frozen shoulder
  
• restricted mobility
  
• shoulder joint degeneration