When the shoulder keeps dislocating or falling out of joint , either completely of partially, the condition is referred to as shoulder instability. This can usually be traced back to a shoulder injury which caused the first dislocation, but may be caused by having lax joints (double-jointed) or by the way the muscles work around the shoulder. Patients with instability of the shoulder can lose confidence in the shoulder during certain activities, fearing that it may come out of joint or slip within the joint, sometimes causing pain. The condition can usually be diagnosed via a specialist shoulder examination. Occasionally a CT or MRI examination is required to confirm the diagnosis or to assess the amount of damage to the shoulder. Physiotherapy is very useful in patients with shoulder instability and can often effect a complete cure.
If the symptoms have arisen from an injury, there may be structural damage to the joint, in which case an operation may be required. This is usually a keyhole operation called an arthroscopic stabilisation, which can be performed as a day-case or with a single overnight stay (click to see an animation about the surgery). It usually takes only a couple of weeks before the shoulder is relatively comfortable, but a return to contact sports will require about 6 months. If there has been bone damage to the socket an alternative, somewhat bigger operation will be offered. This involves a piece of bone from one part of the shoulder or hip being attached to the front of the socket, to replace the bone that has been damaged. The operation is known as a Laterjet or Eden-Hybinette procedure and can leave a scar at the front of the shoulder. The procedure involves a single overnight stay and again takes only a couple of weeks before the shoulder is relatively comfortable. However, a return to contact sports will require about 6 months (click to read more about recovery). The ExeterShoulder surgeons perform about 30 operations a year for instability of the shoulder.