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Shoulder Stabilisation Surgery

Shoulder instability happens to a lot of people. In younger patients, this is usually caused by high-impact sports, while for older patients it’s most commonly due to age-related degeneration, wear and tear over time, reduced flexibility, and decreased muscle strength. If any of these were to happen, a shoulder injury could soon follow. If shoulder stability is impacted too much, then it can cause more injury and become more of an issue to repair.

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Everything you need to know

Shoulder instability happens to a lot of people. In younger patients this is usually caused by high impact sports, while for older patients it’s most commonly due to age-related degeneration, wear and tear over time, reduced flexibility, and decreased muscle strength.

When shoulder instability occurs, it can mean that there’s a:

  • Torn labrum (or a torn glenoid labrum)
  • Torn shoulder lining
  • Damaged to the bicep tendon

If any of these were to happen, a shoulder injury could soon follow. If shoulder stability is impacted too much, then it can cause more injury and become more of an issue to repair.

Signals of the need for shoulder repair include:

  • pain
  • reduced movement
  • repeated dislocation
  • deep vein thrombosis

Before

Shoulder stabilisation surgery will always begin with an initial appointment with an orthopaedic surgeon.

During this appointment, they may run some tests like an X-ray, blood test, or MRI scan. This will allow the surgeon to see the extent of the shoulder instability, in order to decide what the most appropriate type of surgery is, if non-operative treatments have been exhausted.

Before your surgery, you will need to come into hospital for a pre-assessment, where we can check your fitness for surgery. This is a standard check and includes a physical exam, blood tests, heart, and lung function tests.

If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

During

Shoulder stabilisation surgery is usually divided into two options: Bankart repair and the Laterjet procedure.

Bankart lesion repair:

This is a keyhole surgery, usually performed to repair the torn soft tissue. It might be that you have a torn labrum or ligaments in the shoulder, when this is repaired you should find that you regain movement in the shoulder and are able to do normal activities once again. Due to the nature of this procedure, the team can carry out the surgery through a keyhole incision. A keyhole surgery is made through small incisions, which means that it doesn’t tend to leave a large scar and is much less taxing than an open operation.

The Laterjet procedure:

Out of the two surgical options, this is an open surgery that typically is used when there is an injury to the bone at the front of the shoulder socket (the glenoid labrum). The team will take a piece of bone and use it to rebuild the part of the socket where the bone is damaged. This is usually referred to as an open surgery due to the open incision that is required in this surgery.

Both of these surgeries may require the use of general anaesthetic or local anaesthetic – just so that you don’t feel any pain.

After

After you’ve had your shoulder surgery – whether that’s keyhole surgery or open surgery – it’s important that you listen to your body to know how much pain you’re in.

In some cases, you may need to stay overnight in the hospital – this varies from person to person as each procedure is different.

You’ll have your arm in a sling for around four to six weeks after the operation and an upper limb physiotherapist will work with you to gradually regain shoulder strength and range of motion. The rehabilitation process can take from six to twelve months, and it’s crucial to follow the therapist’s guidance and any postoperative instructions provided by your surgeon.

Medically reviewed by Mr Abbas Rashid - BSc(Hons) MBBS FRCS(Tr&Orth) on 02/02/2024

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.