Question 1

What is shoulder instability?

Accepted Answer

Shoulder instability is when the ball (humeral head) slips or dislocates out of the socket (glenoid). Anterior instability (95% of cases) is when shoulder dislocates forward and down. It happens because structures stabilizing the shoulder are damaged: labrum (cartilage rim) tears away from bone (Bankart lesion), capsule (ligament envelope) stretches, and/or bone wears away with recurrent dislocations. After first dislocation, damaged structures don't heal properly, leaving shoulder prone to repeated dislocations. Each subsequent dislocation causes more damage, creating vicious cycle.

Question 2

What is a Bankart lesion?

Accepted Answer

A Bankart lesion is tear of the labrum (cartilage rim around shoulder socket) from the front-lower edge of the glenoid bone. This is THE most common injury causing anterior shoulder instability - happens in 85-90% of traumatic dislocations. When shoulder dislocates forward, labrum tears away taking some capsule (ligament) with it. The labrum and capsule don't heal back to bone properly, leaving shoulder unstable. Surgical repair (Bankart repair) reattaches labrum to bone with anchors and tightens capsule. Bony Bankart is when bone fragment comes off with labrum - more serious and may need different surgery.

Question 3

Will my shoulder keep dislocating?

Accepted Answer

Recurrence risk depends critically on age at first dislocation. Under age 20: 80-90% recurrence risk without surgery. Ages 20-30: 50-60% recurrence. Ages 30-40: 30-40% recurrence. Over age 40: 10-20% recurrence. Other factors: contact sports, bone loss, and number of previous dislocations increase risk. Each dislocation damages shoulder further and increases risk of next dislocation. This is why young patients (under 25) with first dislocation while playing contact sports are often offered early surgery - to prevent cascade of recurrent dislocations.

Question 4

Should I have surgery after my first dislocation?

Accepted Answer

Controversial question. Traditional approach: try rehabilitation first, surgery if dislocates again. Modern approach: early surgery for high-risk patients. Consider surgery after first dislocation if: under age 25 and want to continue contact sports (recurrence risk 80-90% without surgery), significant bone loss or large labral tear on MRI, or occupation/sport makes recurrent instability unacceptable (military, overhead workers). Consider non-surgical if: over age 40 (low recurrence risk 10-20%), not planning contact sports, or able to modify activities. Discuss with specialist - decision depends on your age, activity goals, and imaging findings.

Question 5

What is the difference between arthroscopic repair and Latarjet?

Accepted Answer

Arthroscopic Bankart repair (keyhole surgery): repairs labrum to bone, tightens capsule. Best for: most first-time surgery patients, minimal bone loss (under 20%), less than 3-5 dislocations. Success 85-95% in appropriate patients. Minimal loss of motion. Latarjet procedure (open surgery): transfers coracoid bone to glenoid to restore bone and add sling effect. Best for: significant bone loss (over 20%), failed arthroscopic repair, high-level collision athletes (rugby, martial arts), chronic recurrent instability (over 5 dislocations). Success over 90-95% even in high-risk patients. Recurrence under 5%. Trade-off: more invasive, more loss of external rotation (10-20 degrees), but much lower re-dislocation rate.

Medical Disclaimer

Shoulder Dislocation and Instability

📖What is Shoulder Dislocation and Instability?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention