What is shoulder instability?

The shoulder joint is made up of a ball (the head of the humerus) and a socket (the glenoid). The socket is shallow, with an inner lining of cartilage (the labrum). The ball is kept in place by soft tissues such as muscles and ligaments.

Shoulder instability happens when there is a problem with the labrum or the soft tissues, causing symptoms such as pain, dislocation and a feeling of looseness.

What are the benefits of surgery?

You should get less pain and fewer dislocations and your shoulder should not feel as loose. You may not get back the same strength and range of movement that you had before you damaged your shoulder.

Are there any alternatives to surgery?

Most people can get back good function in their shoulder by changing their activities, and with the help of exercises and physiotherapy.

Simple painkillers such as paracetamol and anti-inflammatory painkillers such as ibuprofen can also help.

A steroid and local-anaesthetic injection into your shoulder can sometimes reduce pain for several months but may cause side effects if repeated too often.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes 45 minutes to two hours.

Your surgeon will make three or four small cuts at the front and back of your shoulder and on the side of your upper arm.

They will insert surgical instruments through the cuts along with a telescope so they can see inside your shoulder and perform the operation.

Your surgeon will use the instruments to remove any scar tissue, release the damaged tissue and repair the torn labrum and ligaments back into the right position.

How can I prepare myself for the operation?

If you smoke, stopping smoking several weeks or more before the operation may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• Bleeding during or after the operation
• Infection of the surgical site (wound)
• Allergic reaction to the equipment, materials or medication
• Chest infection

Specific complications of this operation

• Bleeding into your shoulder
• Restricted shoulder movement
• Infection in your shoulder
• Blood clot (thrombosis) in the axillary vein, which is just under your shoulder joint
• Severe pain, stiffness and loss of use of your arm and hand
• Damage to nerves around your shoulder
• The shoulder continuing to be unstable or to dislocate

Consequences of this procedure

• Pain
• Unsightly scarring of your skin

How soon will I recover?

You should be able to go home the same day. However, your doctor may recommend that you stay a little longer.

The physiotherapist may give you exercises and advice to help you to recover from the operation. Follow any instructions carefully to improve the chance of getting strength and movement back in your shoulder.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

8 in 10 people have a major improvement but it takes time for pain to lessen and movement to increase.

Summary

An unstable shoulder can cause pain, a feeling of looseness in your shoulder joint and dislocation. An operation can help to reduce any pain and allow you to use your shoulder.

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