For some people with a dislocated shoulder, surgical repair may be an option. If you dislocate your shoulder due to a traumatic event, such as a sports collision, fall, or car accident, you may be at risk for repeated shoulder dislocations in the future. The chance of a shoulder dislocation recurring largely depends on your age—younger people are generally at higher risk than older people.
Is surgery required?
If you have a dislocated shoulder and are in doubt about surgery, talk with your healthcare provider about the potential benefits of surgical versus non-surgical treatments.
In general, most orthopaedic surgeons do not recommend surgery after the first shoulder dislocation, but there are exceptions. After a brief period of immobilization, followed by physical therapy, you can gradually return to normal activities.
If you have a persistent second dislocation, surgery may be considered. The younger the age, the higher the risk of redislocation.
Non-surgical treatments are often used to treat shoulder dislocations.
Your healthcare provider will recommend that you start physical therapy to strengthen the muscles that help stabilize the shoulder ball in its socket. While the labrum (cartilage around the shoulder) won’t necessarily heal in its normal position, you can compensate by strengthening the muscles around the shoulder. This method allows you to restore normal movement in your shoulder.
Several studies have shown that keeping the shoulders in a “externally rotated” position — with the upper arm resting on the body and the forearm pointing forward, parallel to the floor — also helps reduce the chance of repeated dislocations. However, this is a rarely used treatment because the position is so awkward, and recent research has not found it to be better than a traditional sling.
The purpose of surgery is to repair the damage that occurs when the shoulder breaks out of the socket.
The most common injury that occurs as a result of a dislocated shoulder is a Bankart tear. This injury is a tear in one of the main stabilizing ligaments that connect to the labrum of the shoulder fossa. The Bankart repair works by reattaching the damaged labrum to the shoulder socket, restoring the normal ligament tension that holds the ball in the socket.
Surgical repair can be done with open surgery or arthroscopic shoulder surgery. Arthroscopic treatment is usually favored. However, in some cases, traditional open surgery may be a better option.
what should you do?
Treatment for shoulder dislocations varies based on symptoms, the extent of the injury, and the risk of redislocation. Often, young athletes participating in contact sports (including soccer or ice hockey) are advised to undergo surgical repair after the first dislocation because the chance of another dislocation without surgery is high.
However, most of the time, when the risk of recurrent dislocations is low, it is reasonable to try nonoperative treatment as a first step in managing these injuries. If a second dislocation occurs, surgery is usually considered.