There is a high rate of return to play your sport after shoulder instability procedures, with most patients returning to the same level of play. Although many athletes can return to play, rates of recurrence can be significant. It’s essential for patients with shoulder injuries to work closely with our Orthopedic team to ensure they follow a comprehensive treatment plan that meets their specific medical needs and goals.
Shoulder stabilization prevents the head of the humerus from coming out of its natural position. It refers to the process of restoring or enhancing the stability of your shoulder joint, which is prone to instability due to its wide range of motion.
The shoulder joint is inherently less stable than other joints in the body, such as the hip or knee, because it sacrifices stability for mobility.
Shoulder instability can result from various factors, including ligament laxity, muscle weakness or imbalance, labral tears, and previous shoulder injuries.
If you are experiencing pain in your shoulders and need medical treatment, please contact Dr. Stephen W. Pournaras, and our professional medical staff can help you recover by simply contacting us today.
Shoulder stabilization procedures are performed to address shoulder instability, which can result from various factors such as ligament laxity, labral tears, bone loss, or muscle weakness. The type of stabilization procedure chosen depends on the underlying cause of instability, the direction of instability (anterior, posterior, or multidirectional), and other individual factors such as age, activity level, and anatomical considerations. Here are the main types of shoulder stabilization procedures:
Bankart Repair (Anterior Stabilization): Bankart repair is a surgical procedure used to stabilize the shoulder following anterior shoulder instability, where the shoulder frequently dislocates or subluxates forward. During this procedure, the torn labrum (a ring of cartilage) and any associated ligaments are reattached and secured to the rim of the glenoid (shoulder socket). Bankart repair can be performed arthroscopically or through an open surgical approach.
Capsular Shift (Multidirectional Stabilization): Capsular shift is a surgical technique used to tighten and reposition the shoulder capsule to address multidirectional instability, where the shoulder is unstable in multiple directions. During this procedure, Dr. Pournaras tightens and plicates (folds) the capsule, effectively reducing its volume and providing additional stability to the shoulder joint. Capsular shift can be performed arthroscopically or through an open surgical approach.
Latarjet Procedure (Anterior Stabilization with Bone Block): The Latarjet procedure is a surgical technique used to stabilize the shoulder joint following anterior shoulder instability, particularly in cases where there is significant bone loss from the glenoid socket. During this procedure, a small piece of bone and attached muscle (usually from the coracoid process of the scapula) is transferred and attached to the front of the glenoid to create a bony block. This helps to prevent further dislocations by increasing the depth of the glenoid socket and providing additional stability to the shoulder joint.
Remplissage (Engaging Hill-Sachs Lesion): Remplissage is a surgical technique used to address engaging Hill-Sachs lesions, which are defects in the humeral head that can occur due to recurrent anterior shoulder dislocations. During this procedure, Dr. Pournaras will fill the defect in the humeral head with soft tissue (usually the posterior capsule or infraspinatus tendon) to prevent engagement of the lesion against the glenoid rim during shoulder movement.
Bone Block Procedures (e.g., Eden-Hybinette Procedure): Bone block procedures involve transferring bone from another part of the body (such as the iliac crest or distal clavicle) and securing it to the deficient area of the shoulder to improve stability. These procedures are typically used in cases of significant bone loss from the glenoid or humeral head.
These are the main types of shoulder stabilization procedures commonly performed to address shoulder instability.
Symptoms of Shoulder Arthritis:
Surgical options for shoulder stabilization in cases of severe instability or recurrent dislocations.
The choice of surgical procedure depends on factors such as the underlying cause of instability, the patient’s age, and activity level.
Arthroscopic Bankart Repair: This is one of the most common surgical procedures for anterior shoulder instability, where the shoulder frequently dislocates or subluxates forward. During an arthroscopic Bankart repair, Dr. Pournaras will use small incisions and a tiny camera (arthroscope) to visualize the inside of the shoulder. Specialized instruments are then used to repair and reattach the torn labrum (a ring of cartilage) to the rim of the glenoid (shoulder socket). Sutures or anchors are typically used to secure the labrum in place.
Latarjet Procedure: is a surgical technique used to treat anterior shoulder instability, particularly in cases with significant bone loss from the glenoid socket. During this procedure, a small piece of bone and attached muscle (usually from the coracoid process of the scapula) is transferred and attached to the front of the glenoid to create a bony block. This helps to prevent further dislocations by increasing the depth of the glenoid socket and providing additional stability to the shoulder.
Capsular Shift: In cases of generalized ligamentous laxity or multidirectional shoulder instability, a capsular shift procedure may be performed to tighten and reinforce the shoulder capsule. During this surgery, Dr. Pournaras will tighten and reposition the soft tissues surrounding the shoulder, effectively reducing the volume of the joint capsule. This helps to improve stability and prevent excessive shoulder movement.
Remplissage: Remplissage is a surgical technique used to address engaging Hill-Sachs lesions, which are defects in the humeral head that can occur due to recurrent anterior shoulder dislocations.
During this procedure, Dr. Pournaras will fill the defect in the humeral head with soft tissue (usually the posterior capsule or infraspinatus tendon) to prevent the lesion from engaging against the glenoid rim during shoulder movement.
Open Capsular Shift: Similar to arthroscopic capsular shift, an open capsular shift procedure involves tightening and repositioning the shoulder capsule to address multidirectional instability. With this approach, Dr. Pournaras will make a larger incision and directly visualize the shoulder to perform the capsular shift.
Bone Block Procedures (e.g., Eden-Hybinette Procedure): In cases of significant bone loss from the glenoid or humeral head, bone block procedures may be considered to reconstruct the bony anatomy of the shoulder. These procedures involve transferring bone from another part of the body (such as the iliac crest or distal clavicle) and securing it to the deficient area of the shoulder to improve stability.
Open Bankart Repair: In cases where arthroscopic Bankart repair is not feasible or effective, an open Bankart repair may be performed. This involves making a larger incision and directly accessing the shoulder joint to repair the torn labrum and capsule.
The specific surgical approach chosen will depend on the individual patient’s condition and anatomical factors.
Physical therapy is typically a crucial component of postoperative rehabilitation to optimize shoulder function and prevent complications.
For over 30 years, Virginia Board Certified Physician, Dr. Stephen W. Pournaras, Jr. has provided excellent healthcare and treatment for his patients. As a multi-specialty orthopedic practice, offering the best for you medically to treat, heal and lead you to optimum recovery. We are dedicated to using state-of-the-art technology while building nurturing relationships with each of our patients.
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