Shoulder Instability Surgery
Currently there a variety of surgical techniques for treating shoulder instability, and it is beyond the scope of this educational presentation to describe the details of each. Therefore, only the general principles and goals will be presented here. The patient's diagnosis is first confirmed by viewing inside the shoulder joint using arthroscopy. The severity of your condition will determine which surgical procedure is indicated.
Two major components of instability need to be surgically evaluated and addressed during arthroscopy. The first is to diagnose and treat the labrum and its attachment to the glenoid bone. A labrum which has torn off of the glenoid may then be repaired either arthroscopically or through an incision using a standard surgical approach. The torn labrum and its associated capsule, must be re-attached to the rim of the glenoid bone. This is done by using either suture or specialized tissue anchoring devices. Many of these devices are absorbable and dissolve after the healing of the labrum to the glenoid takes place.
The second component of shoulder instability is the issue of the capsule's tension. A loose capsule will not hold the humeral head in place and may need to be corrected, based upon the diagnosis during arthroscopy. The capsule may be tightened either through arthroscopic surgery or through a standard surgical approach, depending on the severity of its laxity. The picture below is of an actual shoulder arthroscopy and shows a device which uses heat to shrink the capsule from inside the shoulder joint. If the use of this device is not indicated, an incision and a tightening of the capsule is performed using sutures.
